CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Samaritan Pacific Community Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$105

about 1.1× the $95 Medicare rate · typically $63–$105

modeled estimate · not a bill or quote

What this hospital charges insurers

$105

About the fair price

1.1× Medicare

Medicare pays $95 Fair price $105 This hospital $105 Cash price $154 Hospital's list price $192

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

Highest price of the 9 OR hospitals we have prices for — worth calling around.

Cheapest $48 Priciest $105

Black dot = this hospital, among the 9 OR hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $105 (about 1.1× the $95 Medicare rate). Samaritan Pacific Community Hospital charges insurers about $105, or about $154 in cash — about the fair price. Located in Newport, OR.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana UnitedHealthcareKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
Blue Cross Blue Shieldmajor	$20 - $281	21%
Aetnamajor	$53 - $285	56%
Cignamajor	$54 - $291	57%
Humanamajor	$19 - $292	20%
Devoted Health	$21 - $114	22%
Health Net	$54 - $291	57%
Moda Health	$53 - $285	56%
PacificSource	$21 - $196	22%
+ 4 smaller / regional plans	$18 - $291

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 154), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99213.

Insurance Before you use insurance

Call your insurance company to confirm Samaritan Pacific Community Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 99213.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Samaritan Pacific Community Hospital

Compare: Office visit, established patient (20-29 min) at other OR hospitals

Insurance negotiated median for the same procedure, sorted lowest first.