CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Baptist Memorial Hospital Desoto

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $237
Cash Discount Price: $76
vs. Medicare Baseline: 2.49x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Baptist Memorial Hospital Desoto is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 2.49x the Medicare baseline. Located in 7601 Southcrest Parkway, Southaven, MS.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$237

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: $76 (80%)

Insurance Median: $237 (249%)

Cash: $76 (80% of Medicare)

Ins. Median: $237 (249% 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 249% of the Medicare baseline (a markup of 149%). 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 - $265	57%
Magnolia Ms	$71 - $224	75%
Oscar	$113 - $357	119%
Advanced Health Systems Inc.	$122	128%
Blue Cross Blue Shield	$122 - $613	128%
Ppo Holdings	$122 - $388	128%
Cooper Realty	$129 - $408	136%
Magnolia Regional Health Center	$129 - $408	136%
Multiplan	$138 - $766	145%
UnitedHealthcare	$160 - $1,706	168%
Littler	$161 - $510	169%
Molina	$161 - $510	169%
Humana	$167 - $572	175%
Mpcn	$167 - $531	175%
First Choice Health Plan Of Ms	$171 - $541	180%
Novasys	$187 - $592	196%
Access Health Services	$193 - $613	203%
Primewell	$193 - $613	203%
Qca	$242 - $766	254%
Christian Health Aid	$258 - $817	271%
Ppo Plus	$258 - $817	271%
St. Jude Children'S Hospital	$290 - $919	305%

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 $76.
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 Desoto 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.