CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Pottstown Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$77
about 0.8× the $95 Medicare rate · typically $61–$141
modeled estimate · not a bill or quote
What this hospital charges insurers
$62
Below the fair price — a good deal
about $15 under the fair price · 0.7× Medicare
Medicare pays $95 Fair price $77 This hospital $62 Cash price $56 Hospital's list price $222

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 $62

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 $77 (about 0.8× the $95 Medicare rate). Pottstown Hospital charges insurers about $62, or about $56 in cash — below the fair price — a good deal. Located in Pottstown, PA.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $42 - $68 44%
Blue Cross Blue Shieldmajor $59 - $177 62%
Aetnamajor $51 - $118 54%
Cignamajor $61 - $62 64%
Humanamajor $59 - $62 62%
Geisinger $62 - $121 65%
HealthPartners $62 - $108 65%
UPMC Health Plan $166 174%
+ 2 smaller / regional plans $79 - $265
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: 1600 East High Street, Pottstown, PA 19464
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals