CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: New Ulm Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $126
Cash Discount Price: $168
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at New Ulm Medical Center is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.32x the Medicare baseline. Located in 1324 Fifth North Street, New Ulm, MN.

Cash / Self-Pay

$168

Average discount available for prompt cash payment at this facility.

Insurance Median

$126

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: $168 (176%)

Insurance Median: $126 (132%)

Cash: $168 (176% of Medicare)

Ins. Median: $126 (132% 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
Ucare Pmap (A B C D E G N O S U R H)	$21 - $72	22%
Medica Health System	$34 - $292	36%
Medicaid / KanCare	$46 - $69	48%
Medica	$47 - $277	49%
Medicare (plans)	$47	49%
Blue Cross Blue Shield	$49 - $552	51%
South Country Health Alliance	$52 - $55	55%
Aetna	$65 - $196	68%
Medica Ubh (N)	$74	78%
Hennepin Health	$79	83%
Americas Ppo (Araz)(B D N O R S V)	$82	86%
UnitedHealthcare	$86 - $271	90%
Cigna	$87 - $324	91%
Americas Ppo (Araz) (B D N H O R S)	$89	93%
First Health (A C E G H U B D N O R S)	$89 - $301	93%
All Other Contracted Care (A B C D E G H N O R S U)	$106	111%
Health Partners	$118 - $297	124%
Medica Dual Solutions (A U)	$159	167%
Americas Ppo (Araz)(A M U)	$234 - $240	246%
Medica Ubh (A)	$245 - $251	257%
Medica Mhps	$278	292%
Bc Aware/Blue Plus (Nr)	$382	401%

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 $168.
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 New Ulm 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.