CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Centerpoint Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $621
Cash Discount Price: $1,491
vs. Medicare Baseline: 6.52x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Centerpoint Medical Center is $621. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,491. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 6.52x the Medicare baseline. Located in 19600 East 39Th Street, Independence, MO.

Cash / Self-Pay

$1,491

Average discount available for prompt cash payment at this facility.

Insurance Median

$621

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: $1,491 (1566%)

Insurance Median: $621 (652%)

Cash: $1,491 (1566% of Medicare)

Ins. Median: $621 (652% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 652% of the Medicare baseline (a markup of 552%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$111 - $138	117%
Blue Cross Blue Shield	$150 - $511	158%
Nhc Advantage	$219 - $441	230%
Healthyblue	$231 - $465	243%
Aetna	$254 - $1,185	267%
Coventry	$254 - $934	267%
United	$290 - $1,045	305%
Universal Healthcare	$404 - $813	424%
Coventry Kc Mo	$474 - $952	498%
College Park Family Care Center	$497 - $999	522%
Oha Network	$577 - $1,161	606%
Multiplan	$612 - $1,858	643%
Corvel Corporation	$751 - $1,510	789%
Cigna	$924 - $1,858	971%
Global Sports Services	$924 - $1,858	971%
Cco, Inc.	$982 - $1,975	1032%
Focus Healthcare Mgmt, Inc	$1,039 - $2,091	1092%

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 $1,491.
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 Centerpoint 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.