CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Mercy Hospital Logan County
Billing Code: 99213 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99213
- Insurance Median: $134
- Cash Discount Price: $154
- vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Mercy Hospital Logan County is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.41x the Medicare baseline. Located in 200 S Academy Rd, Guthrie, OK.
Cash / Self-Pay
$154
Average discount available for prompt cash payment at this facility.
Insurance Median
$134
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: $154 (162%)
Insurance Median: $134 (141%)
Cash: $154 (162% of Medicare)
Ins. Median: $134 (141% 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 |
|---|---|---|
| Tricare | $53 - $68 | 56% |
| UnitedHealthcare | $54 - $193 | 57% |
| Aetna | $55 - $162 | 58% |
| Blue Cross Blue Shield | $55 - $138 | 58% |
| Cherokee Nation Health Serv Contracted [320066] | $55 - $70 | 58% |
| Cross Timbers Hospice [20098] | $55 - $70 | 58% |
| Dept Of Veteran Affairs Contracted [320106] | $55 - $70 | 58% |
| Elara Caring Aspire Hospice Contracted [320433] | $55 - $70 | 58% |
| Elara Caring Aspire Hospice [20433] | $55 - $70 | 58% |
| Halo Hcr Inc Hospice Contracted [320432] | $55 - $70 | 58% |
| Halo Hcr Inc Hospice [20432] | $55 - $70 | 58% |
| Humana | $55 - $221 | 58% |
| Independent Health [20197] | $55 - $70 | 58% |
| Indian Health Service Contracted [320198] | $55 - $70 | 58% |
| Kindful Hospice Contracted [320434] | $55 - $70 | 58% |
| Kindful Hospice [20434] | $55 - $70 | 58% |
| Medical Associates Health [20444] | $55 - $70 | 58% |
| Medicare (plans) | $55 - $138 | 58% |
| Mercy Hospice Okc [20252] | $55 - $70 | 58% |
| Provider Partners Health Plans Contracted [320450] | $55 - $70 | 58% |
| Qual Choice Contracted [320325] | $55 - $70 | 58% |
| Tribute Health Plan Mcr Contracted [320338] | $55 - $70 | 58% |
| Cigna | $56 - $235 | 59% |
| Globalhealth Contracted [320145] | $56 - $72 | 59% |
| Ambetter / Centene | $75 - $83 | 79% |
| Home State Health Plan Contracted [320187] | $75 - $83 | 79% |
| Medicaid / KanCare | $75 - $83 | 79% |
| Novasys Contracted [320285] | $75 - $83 | 79% |
| Webtpa Contracted [320417] | $89 - $116 | 93% |
| Medica Contracted [320239] | $106 - $138 | 111% |
| Aither Health Contracted [320449] | $127 - $235 | 133% |
| Auxiant Contracted [320462] | $127 - $235 | 133% |
| Federal Medical Center Contracted [320127] | $127 - $166 | 133% |
| Healthlink Contracted [320179] | $127 - $235 | 133% |
| Healthscope Contracted [320182] | $127 - $166 | 133% |
| Mercy Benefit Admin Contracted [320251] | $127 - $235 | 133% |
| Point C Contracted [320238] | $127 - $166 | 133% |
| Preferred Health Plan Contracted [320522] | $127 - $166 | 133% |
| Quik Trip Contracted [320447] | $127 - $166 | 133% |
| Show-Me Health Administrators Contracted [320483] | $127 - $166 | 133% |
| United Medical Resources Contracted [320454] | $127 - $193 | 133% |
| Health Choice Contracted [320166] | $140 | 147% |
| Osma Health Contracted [320292] | $148 - $193 | 155% |
| United Behavioral Health Contracted [320390] | $148 - $193 | 155% |
| Community Care Contracted [320080] | $150 | 158% |
| Benefit Management Contracted [320052] | $159 - $248 | 167% |
| Globalhealth Contracted [320144] | $159 - $207 | 167% |
| Healthcare Highways Plus Contracted [320175] | $159 - $207 | 167% |
| Private Health Care Systems Contracted [320320] | $159 - $221 | 167% |
| First Health Contracted [320128] | $166 - $216 | 174% |
| Multiplan Contracted [320270] | $170 - $248 | 179% |
| Ebms Contracted [320493] | $180 - $235 | 189% |
| Imagine 360 Contracted [320494] | $180 - $235 | 189% |
| Preferred Community Choice Contracted [320311] | $180 - $235 | 189% |
| Reflect Health Contracted [320492] | $180 - $235 | 189% |
| Yuzu Health Contracted [320521] | $180 - $235 | 189% |