CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Lincoln Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $127
Cash Discount Price: $130
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Lincoln Hospital is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.33x the Medicare baseline. Located in 10 Nichols Street, Davenport, WA.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $130 (137%)

Insurance Median: $127 (133%)

Cash: $130 (137% of Medicare)

Ins. Median: $127 (133% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Ambetter / Centene	$31 - $172	33%
Molina Hlthy Options	$31 - $172	33%
UnitedHealthcare	$31 - $324	33%
Amerigroup Mcaid - All Plans	$33 - $183	35%
Aetna	$37 - $350	39%
Indian Hlth Services - All Plans	$37 - $236	39%
Tricare	$37 - $236	39%
Va Ccn - All Plans	$37 - $236	39%
Cigna	$51 - $281	54%
Focus Healthcare Mgmt - All Plans	$53 - $295	56%
Molina Exchange-All Other Plans	$53 - $335	56%
Asuris Nw Health-All Plans	$58 - $339	61%
Blue Cross Blue Shield	$58 - $324	61%
Uniform Medical Plan-All Plans	$58 - $324	61%
First Health Coventry-All Plans	$59 - $328	62%
Health Management Network-All Plans	$60 - $332	63%
Three Rivers-All Plans	$60 - $332	63%
Multiplan-All Plans	$63 - $350	66%
Physician Hosp Comm Org-All Plans	$63 - $350	66%
First Choice Health- All Plans	$64 - $357	67%
Labor & Industries - All Plans	$117	123%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $130.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99213.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lincoln Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99213.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.