CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Lancaster Rehabilitation Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $175
  • Cash Discount Price: $175
  • vs. Medicare Baseline: 1.84x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Lancaster Rehabilitation Hospital is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $175. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.84x the Medicare baseline. Located in 675 Good Dr, Lancaster, PA.
Cash / Self-Pay
$175

Average discount available for prompt cash payment at this facility.

Insurance Median
$175

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: $175 (184%)
Insurance Median: $175 (184%)
Cash: $175 (184% of Medicare)
Ins. Median: $175 (184% 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.

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
Multiplan $105 110%
Fed Med $114 120%
Aetna $175 184%
All Well - PA Health & Wellness $175 184%
Ambetter / Centene $175 184%
Amerihealth Caritas $175 184%
Blue Cross Blue Shield $175 184%
Cigna $175 184%
Freedom Blue Cpd (Highmark Freedcom Blue) $175 184%
Geha $175 184%
Geisinger $175 184%
Geisinger Gold $175 184%
Geisinger Health Cpd $175 184%
Highmark $175 184%
Highmark (Freedom Blue) $175 184%
Highmark Wholecare McD (Formerly Gateway) $175 184%
Highmark Wholecare Mgg (Formerly Gateway) $175 184%
Humana $175 184%
Medishare $175 184%
Optimum Healthcare $175 184%
Out of Area Blues $175 184%
PA Medical Assistance $175 184%
Preferred Health Care (Eliance) $175 184%
Tricare $175 184%
Triwest $175 184%
UPMC Health Plan $175 184%
UPMC for Life $175 184%
UPMC for You $175 184%
UnitedHealthcare $175 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 675 Good Dr, Lancaster, PA 17601
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL