CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Neshoba County General Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $112
  • Cash Discount Price: $141
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Neshoba County General Hospital is $112. 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 1.18x the Medicare baseline. Located in 1001 Holland Ave, Philadelphia, MS.
Cash / Self-Pay
$141

Average discount available for prompt cash payment at this facility.

Insurance Median
$112

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: $112 (118%)
Cash: $141 (148% of Medicare)
Ins. Median: $112 (118% 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
Magnolia Mcaid $43 - $56 45%
Molina Mcaid $43 - $56 45%
Mpcn Mcaid $43 - $56 45%
UnitedHealthcare $43 - $121 45%
Tricare $50 53%
Humana $55 58%
Magnolia Mcr Adv-All Other Plans $55 58%
Molina Comm-All Other Plans $55 58%
Molina Mcr Adv $55 58%
Wellcare Mcr Adv-All Plans $55 58%
First Choice Comm Ip/Op Only - All Plans $69 72%
Aetna $80 - $121 84%
Cigna $104 - $157 109%
Ahs Ip/Op Only-All Plans $120 - $181 126%
Blue Cross Blue Shield $128 - $193 134%
Affordable Health Care-All Plans $136 - $205 143%
Health Choice Ip/Op Only-All Plans $136 - $205 143%
Health Link Ip/Op Only-All Plans $136 - $205 143%
Geha-All Plans $144 - $218 151%
Multiplan-All Plans $144 - $218 151%
Mpcn Ip/Op Only-All Other Plans $200 - $302 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1001 Holland Ave, Philadelphia, MS 39350
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - CRITICAL ACCESS HOSPITAL