CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Baptist Memorial Hospital North Ms

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $261
Cash Discount Price: $87
vs. Medicare Baseline: 2.74x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Baptist Memorial Hospital North Ms is $261. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 2.74x the Medicare baseline. Located in 1100 Belk Blvd, Oxford, MS.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$261

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: $87 (91%)

Insurance Median: $261 (274%)

Cash: $87 (91% of Medicare)

Ins. Median: $261 (274% 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 274% of the Medicare baseline (a markup of 174%). 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
Aetna	$54 - $632	57%
Magnolia Ms	$72 - $215	76%
Ums Athletic Dept	$91 - $272	96%
Advanced Health Systems Inc.	$122	128%
Blue Cross Blue Shield	$122	128%
Ppo Holdings	$124 - $370	130%
Magnolia Regional Health Center	$130 - $389	137%
UnitedHealthcare	$160 - $1,708	168%
Littler	$163 - $486	171%
Molina	$163 - $486	171%
Mpcn	$170 - $506	179%
Cigna	$179 - $535	188%
Primewell	$196 - $584	206%
Humana	$215 - $642	226%
First Choice Health Plan Of Ms	$228 - $681	240%
Multiplan	$244 - $730	256%
Novasys	$244 - $730	256%
Christian Health Aid	$261 - $778	274%
Ppo Plus	$277 - $827	291%
Qca	$293 - $876	308%

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 $87.
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 Baptist Memorial Hospital North Ms 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.