Office visit, established patient (20-29 min)
Facility: Penn State Health St. Joseph
Billing Code: 99213 (CPT)
This hospital's typical commercial price is $25 compared to the $64 fair price benchmark.
3-Star CMS clinical quality rating paired with 0.39× fair market pricing.
Lowest price of the 9 PA hospitals we have prices for — a strong deal.
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 $64 (about 0.7× the $95 Medicare rate). Penn State Health St. Joseph charges insurers about $25, or about $30 in cash — below the fair price — a good deal. Located in Reading, PA.
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
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 | $45 - $78 | 47% |
| Blue Cross Blue Shieldmajor | $24 - $29 | 25% |
| Aetnamajor | $30 - $59 | 32% |
| Cignamajor | $71 | 75% |
| Geisinger | $83 | 87% |
| UPMC Health Plan | $41 - $85 | 43% |
| + 1 smaller / regional plan | $57 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Penn State Health St. Joseph
Compare: Office visit, established patient (20-29 min) at other PA hospitals
- UPMC Wellsboro · Wellsboro $39
- Surgical Institute of Reading · Wyomissing $40
- St Luke's Hospital - Upper Bucks Campus · Quakertown $42
- Washington Hospital, The · Washington $42
- St Lukes Hospital · Bethlehem $42
- Lower Bucks Hospital · Bristol $42
- UPMC Greene · Waynesburg $42
- St Luke's Hospital - Easton Campus · Easton $42
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Penn State Health St. Joseph (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $42
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $42).
Self-Pay Cash Rate ($30) Beats Your Bill
Penn State Health St. Joseph's published 45 CFR § 180 self-pay cash rate is $30 (vs. $25 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $64 Fair BaseRate ($95 Medicare)
Your bill ($115) is $51 above the denoised Fair BaseRate ($64) and 1.2× the $95 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.