CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: University Hospitals Conneaut Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $98
  • Cash Discount Price: $114
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at University Hospitals Conneaut Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.03x the Medicare baseline. Located in 158 West Main Road, Conneaut, OH.
Cash / Self-Pay
$114

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $114 (120%)
Insurance Median: $98 (103%)
Cash: $114 (120% of Medicare)
Ins. Median: $98 (103% 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
Cigna $27 - $86 28%
Aultcare $31 33%
Jp Farley $42 44%
Aetna $46 - $84 48%
Blue Cross Blue Shield $46 - $153 48%
Devoted $46 - $47 48%
Humana $46 - $47 48%
Medical Mutual Of Ohio $46 - $144 48%
Molina $46 - $47 48%
Primetime Health Plan $46 - $47 48%
Summacare $46 - $78 48%
The Health Plan $46 - $101 48%
UnitedHealthcare $46 - $130 48%
Wellcare By Allwell $46 - $47 48%
Paramount $48 - $49 50%
Perennial Advantage Of Ohio $49 - $50 51%
Valor Health Plans $49 - $50 51%
Amish Aid Community Plan $69 - $70 72%
Amish Church Fund And Workers Aid Plan $69 - $70 72%
Buckeye Plain Ministries $69 - $70 72%
Clarity $72 - $73 76%
Christian Healthcare Ministries $75 - $76 79%
Immergrun $75 - $76 79%
Sunrise Plan Communities $75 - $76 79%
Ambetter / Centene $84 - $85 88%
Caresource $84 - $85 88%
Healthsmart $98 - $99 103%
Ohio Health Choice $98 - $138 103%
Medical Mutual Traditional/Health Ohio $105 - $107 110%
Beech Street $120 - $138 126%
Ohio Preferred Network $120 - $138 126%
First Health $124 - $127 130%
Century Health Network $128 - $130 134%
Private Healthcare System $129 - $132 136%
Configurenet $135 - $138 142%
Fortified Provider Network $135 - $138 142%
Multiplan $135 - $138 142%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 158 West Main Road, Conneaut, OH 44030
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals