CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Trident Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $300
Cash Discount Price: $658
vs. Medicare Baseline: 3.15x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Trident Medical Center is $300. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $658. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 3.15x the Medicare baseline. Located in 9330 Medical Plaza Dr, Charleston, SC.

Cash / Self-Pay

$658

Average discount available for prompt cash payment at this facility.

Insurance Median

$300

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: $658 (691%)

Insurance Median: $300 (315%)

Cash: $658 (691% of Medicare)

Ins. Median: $300 (315% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 315% of the Medicare baseline (a markup of 215%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Choice Health Plan	$50	53%
Blue Cross Blue Shield	$50 - $1,193	53%
Absolute Total Care	$58 - $226	61%
Aetna	$59 - $594	62%
Nhc Advantage	$75 - $239	79%
Pruitt Health	$75 - $239	79%
Sc State Employees	$108	113%
Medcost	$151 - $706	159%
United	$158 - $565	166%
Select Health	$170 - $540	179%
Employers Health Network	$178 - $565	187%
Occunet	$198 - $628	208%
Vocational Rehab	$213 - $678	224%
Humana	$257 - $942	270%
First Health	$288 - $917	303%
Mhnet	$296 - $942	311%
Evernorth	$316 - $1,005	332%
Multiplan	$336 - $1,068	353%
Prime Health	$336 - $1,068	353%
Novanet	$356 - $1,130	374%
United Behavioral Health	$395 - $1,256	415%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $658.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99213.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Trident Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99213.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.