CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Lake Health Beachwood Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $119
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Lake Health Beachwood Medical Center is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.25x the Medicare baseline. Located in 25501 Chagrin Boulevard, Beachwood, OH.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

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: $122 (128%)
Insurance Median: $119 (125%)
Cash: $122 (128% of Medicare)
Ins. Median: $119 (125% 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
Aultcare $31 33%
Jp Farley $42 44%
Amish Aid Community Plan $75 79%
Amish Church Fund And Workers Aid Plan $75 79%
Buckeye Plain Ministries $75 79%
Clarity $78 82%
Summacare $78 - $119 82%
Christian Healthcare Ministries $81 85%
Immergrun $81 85%
Sunrise Plan Communities $81 85%
Healthsmart $105 110%
Ohio Health Choice $105 - $146 110%
Aetna $109 - $213 115%
Blue Cross Blue Shield $119 - $238 125%
Cigna $119 - $360 125%
Devoted Health $119 125%
Humana $119 125%
Medical Mutual Of Ohio $119 125%
Molina $119 - $131 125%
Primetime Health Plan $119 125%
The Health Plan $119 125%
UnitedHealthcare $119 - $302 125%
Wellcare By Allwell $119 125%
Paramount $123 129%
Perennial Advantage Of Ohio $125 131%
Valor Health Plans $125 131%
Beech Street $130 - $146 137%
Ohio Preferred Network $130 - $146 137%
First Health $134 141%
Century Health Network $138 145%
Private Healthcare System $139 146%
Configurenet $146 153%
Fortified Provider Network $146 153%
Multiplan $146 153%
Ambetter / Centene $215 226%
Caresource $215 226%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 25501 Chagrin Boulevard, Beachwood, OH 44122
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals