Office visit, established patient (20-29 min)
Facility: Arbor Health Morton Hospital
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $84
- Cash Discount Price: $80
- vs. Medicare Baseline: 0.88x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Molina Mcr Adv | $38 - $92 | 40% |
| Amerigroup-All Other Plans | $45 - $83 | 47% |
| Comm Health Healthy Options | $45 - $79 | 47% |
| Kaiser Mcaid | $45 - $79 | 47% |
| Molina Mcaid | $45 - $152 | 47% |
| UnitedHealthcare | $45 - $146 | 47% |
| Molina Marketplace-All Other Plans | $46 - $110 | 48% |
| First Choice-All Plans | $51 - $170 | 54% |
| Regence Blue Shield Ump-All Other Plans | $53 - $128 | 56% |
| Comm Health Basic Sub - All Other Plans | $55 - $156 | 58% |
| Premera First-All Other Plans | $68 - $165 | 71% |
| Kaiser Comm-All Other Plans | $70 - $144 | 74% |
| Cigna | $71 - $170 | 75% |
| Comm Health Pebb | $82 - $156 | 86% |
| Aetna | $84 - $161 | 88% |
| Amerigroup Mcr Adv | $84 | 88% |
| Comm Health Mcr Adv | $84 | 88% |
| Healthnet Mcr Adv - All Plans | $84 | 88% |
| Humana | $84 | 88% |
| Mcr Railroad Mcr Adv - All Plans | $84 | 88% |
| Medicare (plans) | $84 | 88% |
| Premera Hmo Mcr Adv | $84 | 88% |
| Rural Health Mcare - All Plans | $84 | 88% |
| Regence Blue Shield Mcr Adv | $85 | 89% |
| Wellcare Mcr Adv - All Plans | $88 | 92% |