CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Essentia Health Deer River

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $83
Cash Discount Price: $118
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Essentia Health Deer River is $83. 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 0.87x the Medicare baseline. Located in 115 10Th Avenue Northeast, Deer River, MN.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$83

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: $83 (87%)

Cash: $118 (124% of Medicare)

Ins. Median: $83 (87% 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
Blue Cross Blue Shield	$41 - $157	43%
Blue Plus Pmap Pcc Prime	$41 - $88	43%
Healthpartners Care Pmap	$43 - $79	45%
Advocare/Security Health	$46 - $84	48%
Freedom Blue Ppo	$46 - $84	48%
Healthpartners Care Msho / Mcr Adv	$46 - $84	48%
Imcare Msho Pcc Prime	$46 - $84	48%
Imcare Msho Ref Req	$46 - $84	48%
Medica Advantage Solutions	$46 - $84	48%
Medica Msho/Dual Solutions	$46 - $84	48%
Medica Prime Solution Group	$46 - $84	48%
Medicare (plans)	$46 - $84	48%
Healthpartners	$72 - $153	76%
America'S Ppo	$83 - $152	87%
Cigna	$83 - $153	87%
Healthpartners Pcc Prime	$83 - $153	87%
Aetna	$91 - $167	96%

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 $118.
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 Essentia Health Deer River 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.