CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Artesia General Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $121
Cash Discount Price: $133
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Artesia General Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.27x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$133

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $133 (140%)

Insurance Median: $121 (127%)

Cash: $133 (140% of Medicare)

Ins. Median: $121 (127% 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.

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
Presbyterian Health Plan	$24 - $66	25%
UnitedHealthcare	$32 - $65	34%
Humana	$33 - $69	35%
Zelis	$35 - $130	37%
First Health	$49 - $235	51%
Blue Cross Blue Shield	$51 - $157	54%
Triwest	$61 - $230	64%
Geha	$63 - $209	66%
Health Net Federal Services	$63	66%
Molina Healthcare Of New Mexico	$63 - $88	66%
New Mexico Health Connections	$66 - $157	69%
Cimarron Advantage	$88	92%
Healthsmart	$88 - $151	92%
Omni Networks	$89 - $183	93%
Cigna	$94 - $235	99%
Three Rivers Provider Network	$95 - $196	100%
Galaxy Health	$114 - $235	120%
One Health Plan	$114 - $235	120%
Multiplan	$116 - $238	122%
United Payors & United Providers	$118 - $243	124%
Providence Risk & Insurance Services	$121 - $248	127%
National Preferred Provider Network	$148 - $159	155%

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 $133.
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 Artesia General Hospital 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.