CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Johnson County Community Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $48
  • Cash Discount Price: $35
  • vs. Medicare Baseline: 0.50x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Johnson County Community Hospital is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.50x the Medicare baseline. Located in 1901 S Shady St, Mountain City, TN.
Cash / Self-Pay
$35

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $35 (37%)
Insurance Median: $48 (50%)
Cash: $35 (37% of Medicare)
Ins. Median: $48 (50% 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
Blue Cross Blue Shield $44 - $116 46%
Aetna $45 - $98 47%
Amerigroup $45 47%
Humana $45 47%
Managed Medicaire $45 47%
Medicare (plans) $45 47%
Sentara Health $45 - $52 47%
United Mine Workers Of America $45 47%
UnitedHealthcare $45 - $72 47%
Wellcare $45 47%
Molina Healthcare $46 48%
Cigna $47 - $73 49%
Devoted Health Plan $47 49%
Nhc Advantage $47 49%
Ambetter / Centene $49 51%
Medcost $54 57%
First Health Coventry $116 122%
Seven Corners, Inc. $154 162%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 S Shady St, Mountain City, TN 37683
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals