CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Mercy Hospital Kingfisher, Inc
Billing Code: 99213 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99213
- Insurance Median: $135
- Cash Discount Price: $177
- vs. Medicare Baseline: 1.42x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Mercy Hospital Kingfisher, Inc is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.42x the Medicare baseline. Located in 1000 Hospital Drive, Kingfisher, OK.
Cash / Self-Pay
$177
Average discount available for prompt cash payment at this facility.
Insurance Median
$135
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: $177 (186%)
Insurance Median: $135 (142%)
Cash: $177 (186% of Medicare)
Ins. Median: $135 (142% 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 |
|---|---|---|
| Aetna | $55 - $220 | 58% |
| Blue Cross Blue Shield | $55 - $167 | 58% |
| Cherokee Nation Health Serv Contracted [320066] | $55 - $135 | 58% |
| Cross Timbers Hospice [20098] | $55 - $135 | 58% |
| Dept Of Veteran Affairs Contracted [320106] | $55 - $135 | 58% |
| Elara Caring Aspire Hospice Contracted [320433] | $55 - $135 | 58% |
| Elara Caring Aspire Hospice [20433] | $55 - $135 | 58% |
| Halo Hcr Inc Hospice Contracted [320432] | $55 - $135 | 58% |
| Halo Hcr Inc Hospice [20432] | $55 - $135 | 58% |
| Humana | $55 - $135 | 58% |
| Independent Health [20197] | $55 - $135 | 58% |
| Indian Health Service Contracted [320198] | $55 - $135 | 58% |
| Kindful Hospice Contracted [320434] | $55 - $135 | 58% |
| Kindful Hospice [20434] | $55 - $135 | 58% |
| Medical Associates Health [20444] | $55 - $135 | 58% |
| Medicare (plans) | $55 - $228 | 58% |
| Mercy Hospice Okc [20252] | $55 - $135 | 58% |
| Provider Partners Health Plans Contracted [320450] | $55 - $135 | 58% |
| Qual Choice Contracted [320325] | $55 - $135 | 58% |
| Tricare | $55 - $135 | 58% |
| UnitedHealthcare | $55 - $224 | 58% |
| Cigna | $56 - $218 | 59% |
| Globalhealth Contracted [320145] | $56 - $138 | 59% |
| Ambetter / Centene | $75 - $96 | 79% |
| Home State Health Plan Contracted [320187] | $75 - $96 | 79% |
| Medicaid / KanCare | $75 - $96 | 79% |
| Novasys Contracted [320285] | $75 - $96 | 79% |
| Medica Contracted [320239] | $76 - $228 | 80% |
| Webtpa Contracted [320417] | $94 - $135 | 99% |
| Aither Health Contracted [320449] | $134 - $273 | 141% |
| Mercy Benefit Admin Contracted [320251] | $134 - $273 | 141% |
| Quik Trip Contracted [320447] | $134 - $193 | 141% |
| Show-Me Health Administrators Contracted [320483] | $134 - $193 | 141% |
| Health Choice Contracted [320166] | $140 | 147% |
| Benefit Management Contracted [320052] | $146 - $241 | 153% |
| United Medical Resources Contracted [320454] | $156 - $224 | 164% |
| Osma Health Contracted [320292] | $157 - $225 | 165% |
| Healthcare Highways Plus Contracted [320175] | $168 - $241 | 176% |
| First Health Contracted [320128] | $175 - $251 | 184% |
| Auxiant Contracted [320462] | $190 - $273 | 200% |
| Ebms Contracted [320493] | $190 - $273 | 200% |
| Healthlink Contracted [320179] | $190 - $273 | 200% |
| Imagine 360 Contracted [320494] | $190 - $273 | 200% |
| Reflect Health Contracted [320492] | $190 - $273 | 200% |
| Yuzu Health Contracted [320521] | $190 - $273 | 200% |