CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Oklahoma Heart Hospital South, LLC

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $141
Cash Discount Price: $87
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Oklahoma Heart Hospital South, LLC is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.48x the Medicare baseline. Located in 5200 East I-240 Service Road, Oklahoma City, OK.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$141

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: $87 (91%)

Insurance Median: $141 (148%)

Cash: $87 (91% of Medicare)

Ins. Median: $141 (148% 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.

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
Healthcare Highways	$62 - $149	65%
Aetna	$78 - $172	82%
Humana	$78 - $172	82%
Healthscope	$115	121%
Oscar Insurance Company	$115	121%
Webtpa Chickasaw Nation Hch	$117	123%
Blue Cross Blue Shield	$128	134%
Cigna	$128	134%
Medicare (plans)	$128 - $132	134%
UnitedHealthcare	$128 - $136	134%
Va Ccn	$128	134%
Webtpa Hobby Lobby Hch	$132	139%
Geha	$136	143%
Coventry	$147	154%
Global Health	$157	165%
Sana Benefits	$162	170%
Ufcw	$162	170%
First Health Network	$172	181%
Manhattan Life	$172	181%
Community Care	$174 - $256	183%
Phcs	$174	183%
Ambetter / Centene	$179	188%
Preferred Community Choice	$189	199%
Multiplan	$224	235%
The Kempton Group	$320	336%

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 $87.
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 Oklahoma Heart Hospital South, LLC 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.