CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Methodist Mansfield Medical Center
Billing Code: 99213 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99213
- Insurance Median: $115
- Cash Discount Price: $211
- vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Methodist Mansfield Medical Center is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.21x the Medicare baseline. Located in 2700 E Broad Street, Mansfield, TX.
Cash / Self-Pay
$211
Average discount available for prompt cash payment at this facility.
Insurance Median
$115
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: $211 (222%)
Insurance Median: $115 (121%)
Cash: $211 (222% of Medicare)
Ins. Median: $115 (121% 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 |
|---|---|---|
| UnitedHealthcare | $30 - $142 | 32% |
| Community Hospice Of Texas [2005] | $57 | 60% |
| Faith Hospice [2008] | $57 | 60% |
| Generic Hospice [2011] | $57 | 60% |
| Heart To Heart Hospice [2012] | $57 | 60% |
| Homebound Cardinal Hospice [4019] | $57 | 60% |
| Hospice Plus [2013] | $57 | 60% |
| Kindful Health Hospice [4016] | $57 | 60% |
| Lions Hospice [2015] | $57 | 60% |
| New Century Hospice [2003] | $57 | 60% |
| Odyssey Hospice [2018] | $57 | 60% |
| Silverado Hospice [4017] | $57 | 60% |
| Vista Care Hospice [2023] | $57 | 60% |
| Vitas Hospice [2024] | $57 | 60% |
| Vna Hospice [2025] | $57 | 60% |
| Medicare (plans) | $61 - $142 | 64% |
| Alternative Service Concepts [8005] | $72 | 76% |
| Oscar Insurance Company [2057] | $75 | 79% |
| Bright Healthcare [2222] | $80 | 84% |
| Molina [3017] | $83 | 87% |
| Wellpoint Marketplace Exchange [3071] | $89 | 93% |
| Aetna | $93 - $134 | 98% |
| 90 Degree Benefit [3057] | $95 | 100% |
| Allied National [2031] | $95 | 100% |
| Entrust/90 Degree [2058] | $95 | 100% |
| Ambetter / Centene | $98 | 103% |
| Friday Health Plan [2061] | $98 | 103% |
| Imperial Insurance Companies [3073] | $103 | 108% |
| Cigna | $106 - $142 | 111% |
| Web Tpa [3049] | $106 | 111% |
| Medicaid / KanCare | $112 - $136 | 118% |
| Department Of Labor [8004] | $115 | 121% |
| Evry Health [1013] | $115 | 121% |
| Generic Workers Comp Tx Non Par [9010] | $115 | 121% |
| Generic Workers Comp Tx Par [8002] | $115 | 121% |
| Generic Workers Comp Tx Par [9011] | $115 | 121% |
| Sana Benefits [3069] | $115 | 121% |
| Tristar Risk Management [8006] | $115 | 121% |
| Velocity [3070] | $115 | 121% |
| Blue Cross Blue Shield | $134 - $275 | 141% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [6005] | $134 | 141% |
| Ust Health Proof [1005] | $134 | 141% |
| Wellcare [7016] | $134 | 141% |
| American Health Advantage Of Texas [7099] | $141 | 148% |
| Globalhealth [1003] | $141 | 148% |
| Procare Advantage [7018] | $141 | 148% |
| Humana | $142 | 149% |
| Southwestern Health Resources Swhr [7015] | $142 | 149% |
| Health Plans Inc [5017] | $143 | 150% |
| Medical Cost Containment Professionals [3059] | $143 | 150% |
| Provider Partners Health Plan [7025] | $145 | 152% |
| Dart Member Care [3039] | $155 | 163% |
| Healthscope Benefits [2052] | $155 | 163% |
| Healthscope Benefits [3063] | $155 | 163% |
| Kempton Group Administrators, Tower Extrusions [3061] | $214 | 225% |