CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Madison Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$68
about 0.7× the $95 Medicare rate · typically $55–$129
modeled estimate · not a bill or quote
What this hospital charges insurers
$75
About the fair price
about $7 over the fair price · 0.8× Medicare
Medicare pays $95 Fair price $68 This hospital $75 Cash price $152 Hospital's list price $179

How we calculate the fair BaseRate →

How this hospital compares to other MN hospitals

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

Cheapest $55 Priciest $75

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

A fair price for a Office visit, established patient (20-29 min) is about $68 (about 0.7× the $95 Medicare rate). Madison Hospital charges insurers about $75, or about $152 in cash — about the fair price. Located in Madison, MN.

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✓ Humana CignaKaiser 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 $41 - $2,713 43%
Blue Cross Blue Shieldmajor $44 - $2,713 46%
Aetnamajor $45 - $217 47%
Humanamajor $51 - $334 54%
HealthPartners $46 - $216 48%
Medica $51 - $204 54%
Sanford Health Plan $87 - $224 91%
+ 1 smaller / regional plan $47 - $351
Government programs also on file: Medicare, Medicaid.
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 820 Third Avenue, Madison, MN 56256
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals