CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: St Francis Medical Center

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$124

about 1.3× the $95 Medicare rate · typically $110–$185

modeled estimate · not a bill or quote

What this hospital charges insurers

$109

Below the fair price — a good deal

about $15 under the fair price · 1.1× Medicare

Medicare pays $95 Fair price $124 This hospital $109 Cash price $96 Hospital's list price $169

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 $109

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 $124 (about 1.3× the $95 Medicare rate). St Francis Medical Center charges insurers about $109, or about $96 in cash — below the fair price — a good deal. Located in Breckenridge, MN.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$47 - $216	49%
Blue Cross Blue Shieldmajor	$15 - $409	16%
Aetnamajor	$64 - $119	67%
Cignamajor	$139 - $372	146%
Humanamajor	$27 - $109	28%
HealthPartners	$27 - $247	28%
Medica	$27 - $239	28%
Sanford Health Plan	$57 - $229	60%
UCare	$27 - $229	28%
+ 2 smaller / regional plans	$71 - $199

Government programs also on file: Medicaid.

Excludes 3 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 96), 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 St Francis Medical Center 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 St Francis Medical Center

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

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