CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Essentia Health Holy Trinity Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $105
  • Cash Discount Price: $118
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Essentia Health Holy Trinity Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.10x the Medicare baseline. Located in 115 Second Street West, Box 157, Graceville, MN.
Cash / Self-Pay
$118

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $118 (124%)
Insurance Median: $105 (110%)
Cash: $118 (124% of Medicare)
Ins. Median: $105 (110% 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.

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
Healthpartners Care Pmap $42 - $76 44%
Medica Access $43 - $100 45%
Sanford Healthplan $46 - $88 48%
Blue Cross Blue Shield $57 - $171 60%
Blue Plus Pmap Pcc Prime $59 - $171 62%
Healthpartners $65 - $130 68%
Advocare/Security Health $66 - $122 69%
Freedom Blue Ppo $66 - $122 69%
Healthpartners Care Msho / Mcr Adv $66 - $122 69%
Imcare Msho Pcc Prime $66 - $122 69%
Imcare Msho Ref Req $66 - $122 69%
Medica Advantage Solutions $66 - $122 69%
Medica Msho/Dual Solutions $66 - $122 69%
Medica Prime Solution Group $66 - $122 69%
Medicare (plans) $66 - $122 69%
Nd Va Administration $66 - $122 69%
Platinum Blue/Vantage Blue $66 - $122 69%
Primewest Msho $66 - $122 69%
Secure Blue Msho $66 - $122 69%
Ubh Cost Plan $66 - $122 69%
Ubh Msho $66 - $122 69%
Ucare Msho $66 - $122 69%
UnitedHealthcare $66 - $177 69%
Ucare $70 - $129 74%
Cigna $71 - $130 75%
Healthpartners Pcc Prime $71 - $130 75%
Wea $77 - $151 81%
America'S Ppo $83 - $152 87%
Medica $89 - $172 93%
Medica Uplan $89 - $163 93%
Wps $89 - $165 93%
Aetna $91 - $167 96%
Medica Choice $96 - $177 101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 115 Second Street West, Box 157, Graceville, MN 56240
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals