CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Howard County Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $102
  • Cash Discount Price: $179
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Howard County Medical Center is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $179. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.07x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.
Cash / Self-Pay
$179

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $179 (188%)
Insurance Median: $102 (107%)
Cash: $179 (188% of Medicare)
Ins. Median: $102 (107% 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
Nebraska Total Care $37 - $90 39%
UnitedHealthcare $37 - $186 39%
Molina Healthcare $38 - $90 40%
Humana $51 - $60 54%
Aetna $60 - $170 63%
Medica Standard Premier $60 63%
Medica CHI $60 - $102 63%
Tricare $60 - $134 63%
Great Plains $60 - $102 63%
Blue Cross Blue Shield $60 - $398 63%
Medica Elevate $61 - $118 64%
Nebraska Total Care - Wellcare $62 65%
Medica Choice National $100 - $163 105%
Medica CHI ACO $100 - $163 105%
Oscar Health $105 110%
Medica Ifb Open Access $106 - $172 111%
Medica Ifb ACO $106 - $172 111%
Ambetter / Centene $120 126%
Beshp $120 126%
Midland's Choice $172 181%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: P O Box 406, 1113 Sherman St, St Paul, NE 68873
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals