CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Greater Baltimore Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $96
Cash Discount Price: $223
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Greater Baltimore Medical Center is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $223. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.01x the Medicare baseline. Located in 6701 North Charles Street, Baltimore, MD.

Cash / Self-Pay

$223

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$95.19

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $95.19 (100%)

Cash / Self-Pay: $223 (234%)

Insurance Median: $96 (101%)

Cash: $223 (234% of Medicare)

Ins. Median: $96 (101% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $95.19 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Carefirst Blue Choice Hmo [253]	$45 - $119	47%
Aetna	$47 - $99	49%
Carefirst Administrator [252]	$48 - $119	50%
Carefirst [201]	$48 - $119	50%
Medicaid / KanCare	$64 - $90	67%
Carefirst Maryland Health Advantage Mca [264]	$69 - $96	72%
Cfchp Mco [239]	$69 - $96	72%
Cigna	$69 - $108	72%
Communicare Advantage [300]	$69 - $96	72%
Humana	$69 - $96	72%
Johns Hopkins [213]	$69 - $129	72%
Keycare Advantage [299]	$69 - $96	72%
Medicare (plans)	$69 - $96	72%
Multiplan/Phcs [296]	$69 - $111	72%
Provider Partners Health Plan [298]	$69 - $96	72%
UnitedHealthcare	$69 - $99	72%
Md Physician Care [237]	$72 - $99	76%
Priority Partners [241]	$72 - $99	76%
Wellpoint [235]	$72 - $99	76%
Alterwood Health [290]	$73 - $101	77%
Jai Medical Services [236]	$75 - $104	79%
First Health Network [268]	$89 - $125	93%
Kaiser Permanente Hmo [231]	$94 - $136	99%
Usa Managed Care Organization [301]	$173	182%
All Payers	$263 - $460	276%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $223.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99213.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Greater Baltimore Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99213.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.