CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Mercy Hospital - Cassville
Billing Code: 99213 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99213
- Insurance Median: $172
- Cash Discount Price: $141
- vs. Medicare Baseline: 1.81x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Mercy Hospital - Cassville is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.81x the Medicare baseline. Located in 94 Main Street, Cassville, MO.
Cash / Self-Pay
$141
Average discount available for prompt cash payment at this facility.
Insurance Median
$172
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: $141 (148%)
Insurance Median: $172 (181%)
Cash: $141 (148% of Medicare)
Ins. Median: $172 (181% 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.
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 |
|---|---|---|
| Medicaid / KanCare | $50 - $122 | 53% |
| Aetna | $56 - $209 | 59% |
| Blue Cross Blue Shield | $56 - $228 | 59% |
| Cherokee Nation Health Serv Contracted [320066] | $56 - $97 | 59% |
| Cigna | $56 - $223 | 59% |
| Cross Timbers Hospice [20098] | $56 - $97 | 59% |
| Elara Caring Aspire Hospice [20433] | $56 - $97 | 59% |
| Globalhealth Contracted [320145] | $56 - $97 | 59% |
| Halo Hcr Inc Hospice Contracted [320432] | $56 - $97 | 59% |
| Halo Hcr Inc Hospice [20432] | $56 - $97 | 59% |
| Healthscope Contracted [320182] | $56 - $98 | 59% |
| Humana | $56 - $200 | 59% |
| Indian Health Service Contracted [320198] | $56 - $97 | 59% |
| Kindful Hospice Contracted [320434] | $56 - $97 | 59% |
| Kindful Hospice [20434] | $56 - $97 | 59% |
| Medical Associates Health Contracted [320444] | $56 - $97 | 59% |
| Medicare (plans) | $56 - $101 | 59% |
| Mercy Hospice Okc [20252] | $56 - $97 | 59% |
| Mercy Mgd Behavioral Health Contracted [320259] | $56 - $97 | 59% |
| Pace Of The Ozarks Contracted [320518] | $56 - $97 | 59% |
| Provider Partners Health Plans Contracted [320450] | $56 - $97 | 59% |
| Qual Choice Contracted [320325] | $56 - $97 | 59% |
| Dept Of Veteran Affairs Contracted [320106] | $68 - $80 | 71% |
| Tricare | $81 - $95 | 85% |
| UnitedHealthcare | $82 - $223 | 86% |
| Administrative Payor Contracted [320005] | $90 - $106 | 95% |
| Centivo Contracted [320505] | $101 - $120 | 106% |
| Ambetter / Centene | $103 - $122 | 108% |
| Home State Health Plan Contracted [320187] | $103 - $122 | 108% |
| Novasys Contracted [320285] | $103 - $122 | 108% |
| Healthlink Contracted [320179] | $129 - $212 | 136% |
| Preferred Health Plan Contracted [320522] | $129 - $153 | 136% |
| Health Systems Inc Contracted [320174] | $159 - $188 | 167% |
| Insurance System Inc Contracted [320465] | $159 - $188 | 167% |
| Point C Contracted [320238] | $159 - $212 | 167% |
| Point C [20238] | $159 - $188 | 167% |
| United Medical Resources Contracted [320454] | $159 - $200 | 167% |
| Workers Comp [20426] | $159 - $212 | 167% |
| Municipal Health Plan Contracted [320271] | $161 - $190 | 169% |
| Medica Contracted [320239] | $178 - $211 | 187% |
| 90 Degree Benefits Contracted [320436] | $179 - $212 | 188% |
| Aither Health Contracted [320449] | $179 - $212 | 188% |
| American Healthcare Alliance Contracted [320020] | $179 - $212 | 188% |
| Auxiant Contracted [320462] | $179 - $212 | 188% |
| Benefit Management Contracted [320052] | $179 - $212 | 188% |
| Ebms Contracted [320493] | $179 - $212 | 188% |
| Edison Health Solutions Contracted [320502] | $179 - $212 | 188% |
| Evolutions Health Care Contracted [320124] | $179 - $212 | 188% |
| Imagine 360 Contracted [320494] | $179 - $212 | 188% |
| Mercy Benefit Admin Contracted [320251] | $179 - $212 | 188% |
| Reflect Health Contracted [320492] | $179 - $212 | 188% |
| Show-Me Health Administrators Contracted [320483] | $179 - $212 | 188% |
| Usa Managed Care Org Contracted [320429] | $179 - $212 | 188% |
| Yuzu Health Contracted [320521] | $179 - $212 | 188% |
| First Health Contracted [320128] | $189 - $223 | 199% |
| Multiplan Contracted [320270] | $189 - $223 | 199% |
| Private Health Care Systems Contracted [320320] | $189 - $223 | 199% |