CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: St Anthony Hospital
Billing Code: 99213 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$96
about 1.0× the $95 Medicare rate · typically $49–$154
modeled estimate · not a bill or quote
Medicare pays $95 Fair price $96 Cash price $135 Hospital's list price $198
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
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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 |
|---|---|---|
| UnitedHealthcaremajor | $188 | 197% |
| Blue Cross Blue Shieldmajor | $158 | 166% |
| Aetnamajor | $188 | 197% |
| Cignamajor | $107 - $111 | 112% |
| Health Net | $178 | 187% |
| Moda Health | $64 - $135 | 67% |
| PacificSource | $188 | 197% |
| + 2 smaller / regional plans | $168 - $188 |
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Other Procedures at St Anthony Hospital
Compare: Office visit, established patient (20-29 min) at other OR hospitals
- Saint Alphonsus Medical Center Ontario · Ontario $48
- McKenzie-Willamette Medical Center · Springfield $50
- Santiam Hospital & Clinics · Stayton $59
- Shriners Hospital for Children - Portland · Portland $74
- Wallowa Memorial Hospital · Enterprise $75
- Adventist Health Portland · Portland $86
- Mid-Columbia Medical Center · The Dalles $95
- Lower Umpqua Hospital District · Reedsport $98
Insurance negotiated median for the same procedure, sorted lowest first.