CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Bmh-Golden Triangle

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $283
Cash Discount Price: $102
vs. Medicare Baseline: 2.97x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Bmh-Golden Triangle is $283. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 2.97x the Medicare baseline. Located in 2520 5Th Street N, Columbus, MS.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$283

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: $102 (107%)

Insurance Median: $283 (297%)

Cash: $102 (107% of Medicare)

Ins. Median: $283 (297% 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 297% of the Medicare baseline (a markup of 197%). 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 - $555	57%
Magnolia Ms	$80 - $201	84%
Advanced Health Systems Inc.	$122	128%
Blue Cross Blue Shield	$122	128%
Ppo Holdings	$135 - $337	142%
Magnolia Regional Health Center	$142 - $355	149%
UnitedHealthcare	$160 - $1,709	168%
Littler	$177 - $444	186%
Molina	$177 - $444	186%
Mpcn	$184 - $461	193%
Cigna	$195 - $488	205%
Primewell	$212 - $532	223%
Humana	$234 - $585	246%
First Choice Health Plan Of Ms	$248 - $621	261%
Multiplan	$266 - $665	279%
Novasys	$266 - $665	279%
Christian Health Aid	$283 - $710	297%
Ppo Plus	$301 - $754	316%
Qca	$319 - $798	335%

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 $102.
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 Bmh-Golden Triangle 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.