CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Clarion Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$65
about 0.7× the $95 Medicare rate · typically $45–$116
modeled estimate · not a bill or quote
What this hospital charges insurers
$65
About the fair price
0.7× Medicare
Medicare pays $95 Fair price $65 This hospital $65 Cash price $113 Hospital's list price $203

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

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

Cheapest $25 Priciest $65

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

A fair price for a Office visit, established patient (20-29 min) is about $65 (about 0.7× the $95 Medicare rate). Clarion Hospital charges insurers about $65, or about $113 in cash — about the fair price. Located in Clarion, PA.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser 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 $61 - $76 64%
Aetnamajor $90 - $200 95%
Cignamajor $90 - $112 95%
Devoted Health $72 - $90 76%
UPMC Health Plan $28 - $122 29%
+ 4 smaller / regional plans $63 - $169
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals