CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Curry General Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $123
Cash Discount Price: $186
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Curry General Hospital is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $186. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.29x the Medicare baseline. Located in 94220 Fourth Street, Gold Beach, OR.

Cash / Self-Pay

$186

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $186 (195%)

Insurance Median: $123 (129%)

Cash: $186 (195% of Medicare)

Ins. Median: $123 (129% 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
Partnership Health Plan Of Calif Mdcd Hmo [2008]	$31 - $40	33%
Tricare	$38 - $78	40%
Blue Cross Blue Shield	$63 - $249	66%
Covid19 Hrsa Uninsured Testing And Treatment Fund [2271]	$71 - $108	75%
Medicare (plans)	$71 - $162	75%
Medicaid / KanCare	$77 - $162	81%
Department Of Corrections [1051]	$80 - $162	84%
Coordinated Care Commercial [1649]	$105 - $212	110%
Pacificsource [1148]	$105 - $212	110%
Moda [512]	$106 - $224	111%
Multiplan [1131]	$112 - $227	118%
Asuris [1258]	$117 - $237	123%
Operating Engineers [1144]	$117 - $237	123%
Regence [1351]	$117 - $249	123%
Cigna	$121 - $249	127%
Coventry First Health Managed Care [1774]	$121 - $244	127%
Coventry Health [1046]	$121 - $244	127%
Providence Health Plan Plm Alt [1692]	$121 - $244	127%
Providence Health Plan [567]	$121 - $244	127%
Aetna	$123 - $249	129%
Employee Bene Admin Mgmt [525]	$123 - $249	129%
Geha [531]	$123 - $249	129%
Mailhandlers Benefit Pln [547]	$123 - $249	129%
Meritain [550]	$123 - $249	129%
Nw Sheet Metal Workers [597]	$123 - $249	129%
Trustmark [524]	$123 - $249	129%
UnitedHealthcare	$123 - $249	129%
Zenith Administrators [586]	$123 - $249	129%
First Choice Health Admin [1294]	$193	203%
First Choice [528]	$193	203%
Allcare Alt [2598]	$2,000	2101%
Allcare [1695]	$2,000	2101%

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 $186.
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 Curry General Hospital 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.