CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Falls Community Hospital and Clinic

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$92
about 1.0× the $95 Medicare rate · typically $62–$95
modeled estimate · not a bill or quote
What this hospital charges insurers
$65
Below the fair price — a good deal
about $27 under the fair price · 0.7× Medicare
Medicare pays $95 Fair price $92 This hospital $65 Cash price $200 Hospital's list price $250

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $34 Priciest $65

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Office visit, established patient (20-29 min) is about $92 (about 1.0× the $95 Medicare rate). Falls Community Hospital and Clinic charges insurers about $65, or about $200 in cash — below the fair price — a good deal. Located in Marlin, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $65 - $212 68%
Blue Cross Blue Shieldmajor $50 - $234 53%
Aetnamajor $129 - $242 136%
Cignamajor $32 - $61 34%
Humanamajor $65 68%
Baylor Scott & White $65 68%

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 322 Coleman Street, Marlin, TX 76661
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Rural Emergency Hospital