Office visit, established patient (20-29 min)
Facility: St Charles Hospital
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $155
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.63x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $43 - $298 | 45% |
| Fidelis Care New York | $49 | 51% |
| Health First | $62 | 65% |
| Health Plus | $65 | 68% |
| Us Family Health Plan | $71 | 75% |
| Centers Plan For Healthy Living | $93 | 98% |
| Surest | $93 | 98% |
| Zadroga | $112 | 118% |
| Beacon Health Strategies | $124 | 130% |
| Emblem Health | $124 - $155 | 130% |
| Liberty Health | $124 | 130% |
| Oscar Health | $127 | 133% |
| Magellan | $135 | 142% |
| American Plan Administrators | $140 | 147% |
| Amerihealth Administrators | $140 | 147% |
| Benefit Services | $140 | 147% |
| Ghi Cbp Ny City Employee Alternate | $140 | 147% |
| International Benefit Administrator | $140 | 147% |
| Ultra Benefits Inc. | $140 | 147% |
| Aetna | $155 | 163% |
| Apwu | $155 | 163% |
| Beacon Health Options | $155 | 163% |
| Blue Cross Blue Shield | $155 - $298 | 163% |
| Brighton | $155 - $217 | 163% |
| Centivo | $155 | 163% |
| Cigna | $155 - $202 | 163% |
| Daniel H Cook | $155 | 163% |
| Local 1199 | $155 | 163% |
| Mail Handlers Benefit Plan | $155 | 163% |
| Meritain Health | $155 | 163% |
| Mvp Health Plans | $155 | 163% |
| Nalc | $155 | 163% |
| Nippon Life Insurance Company Of America | $155 | 163% |
| Salvation Army | $155 | 163% |
| Samba | $155 | 163% |
| Allied Wellfare Fund | $202 | 212% |
| American Group Administrators | $202 | 212% |
| Bakery & Confectionery Union | $202 | 212% |
| Comprehensive Benefits Consultant | $202 | 212% |
| Guardian Life Insurance Company Of America | $202 | 212% |
| Maloney And Assoc | $202 | 212% |
| Multiplan | $202 | 212% |
| Performax | $202 | 212% |
| Phcs | $202 | 212% |
| Pomco | $202 | 212% |
| Tpa Inc | $202 | 212% |
| Unicare | $202 | 212% |
| United Employees Health Plan | $202 | 212% |
| Coventry | $229 - $264 | 241% |
| Longevity Health Plan | $248 | 261% |
| Galaxy | $279 | 293% |
| Three Rivers Provider Network | $279 | 293% |
| Self Pay | $298 | 313% |
| Aither Health | $310 | 326% |
| Alpha Care | $310 | 326% |
| Dentaquest | $310 | 326% |
| Veterans Affairs | $310 | 326% |