CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Southern Ohio Medical Center

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$72
about 0.8× the $95 Medicare rate · typically $58–$103
modeled estimate · not a bill or quote
What this hospital charges insurers
$62
Below the fair price — a good deal
about $10 under the fair price · 0.7× Medicare
Medicare pays $95 Fair price $72 This hospital $62 Cash price $175 Hospital's list price $350

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

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

Cheapest $37 Priciest $62

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

A fair price for a Office visit, established patient (20-29 min) is about $72 (about 0.8× the $95 Medicare rate). Southern Ohio Medical Center charges insurers about $62, or about $175 in cash — below the fair price — a good deal. Located in Portsmouth, OH.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $35 - $341 37%
Blue Cross Blue Shieldmajor $34 - $302 36%
Aetnamajor $71 - $298 75%
Cignamajor $90 - $321 95%
Humanamajor $43 - $329 45%
Ambetter (Centene) $62 65%
CareSource $75 79%
Medical Mutual $62 - $317 65%
Molina $43 - $136 45%
WellCare $43 - $62 45%
+ 5 smaller / regional plans $62 - $341
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 1805 27Th Street, Portsmouth, OH 45662
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals