CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Lee's Summit Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $417
Cash Discount Price: $1,200
vs. Medicare Baseline: 4.38x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Lee's Summit Medical Center is $417. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,200. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 4.38x the Medicare baseline. Located in 2100 Se Blue Parkway, Lees Summit, MO.

Cash / Self-Pay

$1,200

Average discount available for prompt cash payment at this facility.

Insurance Median

$417

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: $1,200 (1261%)

Insurance Median: $417 (438%)

Cash: $1,200 (1261% of Medicare)

Ins. Median: $417 (438% 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 438% of the Medicare baseline (a markup of 338%). 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
Blue Cross Blue Shield	$103 - $372	108%
Humana	$111 - $138	117%
Nhc Advantage	$151 - $262	159%
Healthyblue	$159 - $276	167%
Coventry	$175 - $554	184%
Aetna	$182 - $703	191%
United	$199 - $621	209%
Universal Healthcare	$278 - $483	292%
Coventry Kc Mo	$325 - $566	341%
College Park Family Care Center	$341 - $593	358%
Oha Network	$397 - $690	417%
Multiplan	$420 - $1,103	441%
Corvel Corporation	$516 - $897	542%
Focus Healthcare Mgmt, Inc	$595 - $1,034	625%
Cigna	$635 - $1,103	667%
Cco, Inc.	$674 - $1,172	708%

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 $1,200.
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 Lee's Summit 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.