CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: UPMC Chautauqua at Wca

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$71

about 0.7× the $95 Medicare rate · typically $55–$98

modeled estimate · not a bill or quote

What this hospital charges insurers

$59

Below the fair price — a good deal

about $12 under the fair price · 0.6× Medicare

Medicare pays $95 Fair price $71 This hospital $59 Cash price $127 Hospital's list price $212

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

One of the lower prices — 7 of 8 other NY hospitals charge more for the same procedure.

Cheapest $56 Priciest $66

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

A fair price for a Office visit, established patient (20-29 min) is about $71 (about 0.7× the $95 Medicare rate). UPMC Chautauqua at Wca charges insurers about $59, or about $127 in cash — below the fair price — a good deal. Located in Jamestown, NY.

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✓ Aetna✓ Humana Blue Cross Blue ShieldCignaKaiser 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	$32 - $169	34%
Aetnamajor	$59 - $169	62%
Humanamajor	$122 - $208	128%
Fidelis Care	$49	51%
Geisinger	$49	51%
HealthPartners	$53	56%
Independent Health	$129 - $151	136%
MagnaCare	$65 - $195	68%
UPMC Health Plan	$44 - $156	46%
+ 2 smaller / regional plans	$58 - $208

Excludes 3 rental-network / third-party entries (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 127), 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 UPMC Chautauqua at Wca 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 UPMC Chautauqua at Wca

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

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