CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Penn Presbyterian Medical Center
Billing Code: 99213 (CPT)
The BaseRate · fair price high confidence
A fair price for this
$78
about 0.8× the $95 Medicare rate · typically $64–$143
modeled estimate · not a bill or quote
Medicare pays $95 Fair price $78 Cash price $777 Hospital's list price $777
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 | $69 - $777 | 72% |
| Blue Cross Blue Shieldmajor | $194 - $777 | 204% |
| Aetnamajor | $216 - $777 | 227% |
| Cignamajor | $246 - $299 | 258% |
| Humanamajor | $622 | 653% |
| Clover Health | $777 | 816% |
| Geisinger | $777 | 816% |
| Health Net | $466 | 490% |
| HealthPartners | $43 - $777 | 45% |
| Oscar Health | $777 | 816% |
| UPMC Health Plan | $194 - $777 | 204% |
| + 33 smaller / regional plans | $51 - $777 |
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Penn Presbyterian Medical Center
Compare: Office visit, established patient (20-29 min) at other PA hospitals
- Penn State Health St. Joseph · Reading $25
- UPMC Wellsboro · Wellsboro $39
- Surgical Institute of Reading · Wyomissing $40
- Geisinger-Community Medical Center · Scranton $41
- Geisinger-Bloomsburg Hospital · Bloomsburg $41
- Geisinger Wyoming Valley Medical Center · Wilkes Barre $41
- Geisinger Jersey Shore Hospital · Jersey Shore $41
- St Luke's Hospital - Upper Bucks Campus · Quakertown $42
Insurance negotiated median for the same procedure, sorted lowest first.