CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Alliancehealth Durant

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $3,661
Cash Discount Price: $606
vs. Medicare Baseline: 38.46x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Alliancehealth Durant is $3,661. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $606. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 38.46x the Medicare baseline. Located in 1800 University Boulevard, Durant, OK.

Cash / Self-Pay

$606

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,661

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: $606 (637%)

Insurance Median: $3,661 (3846%)

Cash: $606 (637% of Medicare)

Ins. Median: $3,661 (3846% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 3846% of the Medicare baseline (a markup of 3746%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Veterans Eval Services	$84	88%
Node Us Dept Of Labor	$90	95%
Healthchoice	$140	147%
Self Pay	$707	743%
Blue Cross Blue Shield	$742	779%
Cigna	$1,358	1427%
UnitedHealthcare	$1,469	1543%
Healthcare Highways	$1,681	1766%
Customer Linx	$3,030	3183%
Phcs Savility	$3,535	3714%
Aetna	$3,787	3978%
First Health	$3,787	3978%
Healthsmart	$3,838	4032%
Multiplan Complementary	$4,040	4244%
Multiplan Primary	$4,040	4244%
Prime Health Services	$4,040	4244%
One Health Plan	$4,292	4509%
Preferred Community Choice Ppo	$4,292	4509%
Comprehensive Medical Care	$4,544	4774%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $606.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99213.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Alliancehealth Durant is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99213.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.