Office visit, established patient (20-29 min)
Facility: St Clare Hospital
Billing Code: 99213 (CPT)
This hospital's typical commercial price is $325 compared to the $155 fair price benchmark.
4-Star CMS clinical quality rating paired with 2.10× fair market pricing.
Highest price of the 9 WA hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 WA hospitals with a price for this procedure. Full list below.
A fair price for a Office visit, established patient (20-29 min) is about $155 (about 1.6× the $95 Medicare rate). St Clare Hospital charges insurers about $325, or about $125 in cash — well above the fair price. Located in Lakewood, WA.
This price is above the fair BaseRate — you may be able to pay less
Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $155. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
2 of 6 major insurers have a published price at this hospital
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 |
|---|---|---|
| Aetnamajor | $312 - $490 | 328% |
| Cignamajor | $87 | 91% |
| + 1 smaller / regional plan | $480 |
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.
Other Procedures at St Clare Hospital
Compare: Office visit, established patient (20-29 min) at other WA hospitals
- Multicare Auburn Medical Center · Auburn $45
- Multicare Good Samaritan Hospital · Puyallup $45
- Tacoma General Allenmore Hospital · Tacoma $45
- Multicare Covington Medical Center · Covington $45
- Mary Bridge Children's Hospital · Tacoma $45
- Arbor Health Morton Hospital · Morton $48
- Lincoln Hospital · Davenport $51
- Shriners Hospital for Children · Spokane $58
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at St Clare Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $157
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $157).
Self-Pay Cash Rate ($125) Beats Your Bill
St Clare Hospital's published 45 CFR § 180 self-pay cash rate is $125 (vs. $325 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $155 Fair BaseRate ($95 Medicare)
Your bill ($433) is $278 above the denoised Fair BaseRate ($155) and 4.6× the $95 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.