Office visit, established patient (20-29 min)
Facility: University Hospitals - Elyria Medical Center
Billing Code: 99213 (CPT)
This hospital's typical commercial price is $91 compared to the $80 fair price benchmark.
4-Star CMS clinical quality rating paired with 1.14× fair market pricing.
Highest price of the 9 OH hospitals we have prices for — worth calling around.
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 $80 (about 0.8× the $95 Medicare rate). University Hospitals - Elyria Medical Center charges insurers about $91, or about $126 in cash — about the fair price. Located in Elyria, 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
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 | $91 - $101 | 96% |
| Blue Cross Blue Shieldmajor | $77 - $91 | 81% |
| Aetnamajor | $50 - $91 | 53% |
| Cignamajor | $91 - $93 | 96% |
| Humanamajor | $91 | 96% |
| Ambetter (Centene) | $164 | 172% |
| CareSource | $164 | 172% |
| Devoted Health | $91 | 96% |
| Health Net | $143 | 150% |
| Medical Mutual | $55 - $118 | 58% |
| Molina | $91 | 96% |
| Paramount | $94 | 99% |
| WellCare | $91 | 96% |
| + 16 smaller / regional plans | $32 - $900 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at University Hospitals - Elyria Medical Center
Compare: Office visit, established patient (20-29 min) at other OH hospitals
- Uhhs Memorial Hospital of Geneva · Geneva $37
- University Hospitals Conneaut Medical Center · Conneaut $42
- Cincinnati Children's Hospital Medical Center · Cincinnati $42
- Mount Carmel Dublin · Dublin $55
- Wooster Community Hospital · Wooster $57
- Memorial Hospital · Marysville $57
- Mercy Medical Center · Canton $59
- Lutheran Hospital · Cleveland $59
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at University Hospitals - Elyria Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $61
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $61).
Self-Pay Cash Rate ($126) Beats Your Bill
University Hospitals - Elyria Medical Center's published 45 CFR § 180 self-pay cash rate is $126 (vs. $91 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $80 Fair BaseRate ($95 Medicare)
Your bill ($168) is $88 above the denoised Fair BaseRate ($80) and 1.8× the $95 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.