CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Comanche County Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $94
  • Cash Discount Price: $113
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Comanche County Medical Center is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.99x the Medicare baseline. Located in 10201 Hwy 16, Comanche, TX.
Cash / Self-Pay
$113

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $113 (119%)
Insurance Median: $94 (99%)
Cash: $113 (119% of Medicare)
Ins. Median: $94 (99% 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
Choicecare Comm - All Other Plans $35 - $94 37%
Choicecare Mcr Adv $35 - $94 37%
Humana $35 - $177 37%
Molina Mcr Adv - All Other Plans $35 - $94 37%
Pphp Mcr Adv - All Plans $35 - $94 37%
Superior Epo/Hmo - All Plans $35 - $94 37%
Swhp Mcr Adv $35 - $94 37%
Wellmed Mcr Adv - All Plans $35 - $94 37%
Alliance Wc - All Plans $52 - $140 55%
Aetna $59 - $159 62%
Molina Mcaid $59 - $159 62%
Swhp Mcaid $59 - $159 62%
Cigna $61 - $164 64%
Occunet - All Plans $70 - $190 74%
Swhp Comm - All Other Plans $75 - $202 79%
First Care Hmo - All Other Plans $80 - $215 84%
First Care Hmo Self Funded $80 - $215 84%
Mpi - All Plans $85 - $228 89%
Blue Cross Blue Shield $137 - $144 144%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10201 Hwy 16, Comanche, TX 76442
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals