CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Fairview Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$143

about 1.5× the $95 Medicare rate · typically $76–$153

modeled estimate · not a bill or quote

What this hospital charges insurers

$119

Below the fair price — a good deal

about $24 under the fair price · 1.3× Medicare

Medicare pays $95 Fair price $143 This hospital $119 Cash price $177 Hospital's list price $186

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

Highest price of the 9 MA hospitals we have prices for — worth calling around.

Cheapest $30 Priciest $119

Black dot = this hospital, among the 9 MA hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $143 (about 1.5× the $95 Medicare rate). Fairview Hospital charges insurers about $119, or about $177 in cash — below the fair price — a good deal. Located in Great Barrington, MA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$45 - $360	47%
Blue Cross Blue Shieldmajor	$50 - $356	53%
Aetnamajor	$52 - $316	55%
Cignamajor	$133 - $389	140%
MVP Health Care	$62 - $377	65%
UniCare	$96 - $272	101%
+ 14 smaller / regional plans	$39 - $412

Government programs also on file: Medicare, Medicaid.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 177), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99213.

Insurance Before you use insurance

Call your insurance company to confirm Fairview Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 99213.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Fairview Hospital

Compare: Office visit, established patient (20-29 min) at other MA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.