CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Winkler County Memorial Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $179
  • Cash Discount Price: $182
  • vs. Medicare Baseline: 1.88x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Winkler County Memorial Hospital is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $182. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.88x the Medicare baseline. Located in 821 Jeffee Drive, Kermit, TX.
Cash / Self-Pay
$182

Average discount available for prompt cash payment at this facility.

Insurance Median
$179

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: $182 (191%)
Insurance Median: $179 (188%)
Cash: $182 (191% of Medicare)
Ins. Median: $179 (188% 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 $77 - $160 81%
Aetna $137 - $209 144%
Caprock Mcr Adv- All Plans $137 - $160 144%
Molina Marketplace - All Other Plans $137 - $160 144%
Molina Mcr Adv $137 - $160 144%
Superior Mcr Adv - All Other Plans $137 - $160 144%
Humana $138 - $209 145%
UnitedHealthcare $196 - $245 206%
First Care Chip - All Other Plans $211 - $245 222%
First Care Star $211 - $245 222%
Molina Chip $211 - $245 222%
Molina Mcaid $211 - $245 222%
Superior Star/Chip $211 - $245 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 821 Jeffee Drive, Kermit, TX 79745
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals