CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Great Plains Health

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$144

about 1.5× the $95 Medicare rate · typically $115–$327

modeled estimate · not a bill or quote

What this hospital charges insurers

$133

About the fair price

about $11 under the fair price · 1.4× Medicare

Medicare pays $95 Fair price $144 This hospital $133 Cash price $105 Hospital's list price $276

How we calculate the fair BaseRate →

How this hospital compares to other NE hospitals

Highest price of the 9 NE hospitals we have prices for — worth calling around.

Cheapest $50 Priciest $133

Black dot = this hospital, among the 9 NE hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $144 (about 1.5× the $95 Medicare rate). Great Plains Health charges insurers about $133, or about $105 in cash — about the fair price. Located in North Platte, NE.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$140 - $192	147%
Blue Cross Blue Shieldmajor	$130 - $135	137%
Aetnamajor	$138 - $192	145%
Ambetter (Centene)	$135 - $267	142%
GEHA	$138 - $190	145%
Medica	$135 - $186	142%
Molina	$64	67%
Oscar Health	$137 - $188	144%
+ 3 smaller / regional plans	$59 - $192

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 105), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99213.

Insurance Before you use insurance

Call your insurance company to confirm Great Plains Health is in-network.
Ask your insurer whether prior approval is required for CPT code 99213.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Great Plains Health

Compare: Office visit, established patient (20-29 min) at other NE hospitals

Insurance negotiated median for the same procedure, sorted lowest first.