CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Wood County Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $168
  • Cash Discount Price: $198
  • vs. Medicare Baseline: 1.76x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Wood County Hospital is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.76x the Medicare baseline. Located in 950 West Wooster Street, Bowling Green, OH.
Cash / Self-Pay
$198

Average discount available for prompt cash payment at this facility.

Insurance Median
$168

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: $198 (208%)
Insurance Median: $168 (176%)
Cash: $198 (208% of Medicare)
Ins. Median: $168 (176% 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
Blue Cross Blue Shield $52 - $184 55%
Aetna $63 - $191 66%
Buckeye $63 - $106 66%
Caresource $63 - $75 66%
Humana $63 - $214 66%
Medicare (plans) $63 66%
Mmo $63 - $207 66%
Paramount $63 - $186 66%
Perennial $63 66%
Summacare $63 66%
United_Healthcare $63 - $207 66%
Medigold $64 67%
Valor $66 69%
Frontpath $95 - $186 100%
Advanced_Medical_Pricing $98 - $191 103%
Cigna $98 - $191 103%
Medben $98 - $191 103%
Occunet $98 - $191 103%
Ohio_Health_Choice $101 - $212 106%
Claimdoc $104 - $202 109%
First_Health $107 - $209 112%
Health_Ohio_Network $107 - $209 112%
Healthscope_Benefits $111 - $216 117%
Primary_Health_Services_Dca $111 - $216 117%
Multiplan $112 - $219 118%
Private_Healthcare_Systems $112 - $219 118%
Three_Rivers_Provider_Network $112 - $219 118%
Unicare $112 - $219 118%
Beech_Street $113 - $221 119%
Flora $113 - $221 119%
Npn_Medical_Resources $113 - $221 119%
Ohio_Preferred_Provider_Network $113 - $221 119%
Ohio_Health_Group $115 - $226 121%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 950 West Wooster Street, Bowling Green, OH 43402
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals