CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Baptist Memorial Hospital Booneville

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $333
Cash Discount Price: $143
vs. Medicare Baseline: 3.50x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Baptist Memorial Hospital Booneville is $333. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 3.50x the Medicare baseline. Located in 100 Hospital Street, Booneville, MS.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$333

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: $143 (150%)

Insurance Median: $333 (350%)

Cash: $143 (150% of Medicare)

Ins. Median: $333 (350% 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 350% of the Medicare baseline (a markup of 250%). 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 - $558	57%
Magnolia Ms	$64 - $202	67%
Ppo Holdings	$107 - $339	112%
Magnolia Regional Health Center	$113 - $356	119%
Advanced Health Systems Inc.	$122	128%
Blue Cross Blue Shield	$122	128%
Littler	$141 - $446	148%
Molina	$141 - $446	148%
Mpcn	$147 - $463	154%
Cigna	$155 - $490	163%
Primewell	$169 - $535	178%
UnitedHealthcare	$169 - $535	178%
Humana	$186 - $588	195%
First Choice Health Plan Of Ms	$197 - $624	207%
Multiplan	$212 - $668	223%
Novasys	$212 - $668	223%
Christian Health Aid	$226 - $713	237%
Ppo Plus	$240 - $757	252%
Qca	$254 - $802	267%

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 $143.
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 Booneville 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.