CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Snoqualmie Valley Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $88
Cash Discount Price: $76
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Snoqualmie Valley Hospital is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.92x the Medicare baseline. Located in 9801 Frontier Ave Se, Snoqualmie, WA.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $76 (80%)

Insurance Median: $88 (92%)

Cash: $76 (80% of Medicare)

Ins. Median: $88 (92% 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
Aetna	$11 - $131	12%
Amerigroup Wellpoint	$11 - $111	12%
Blue Shield Of Wa Regence Mcr Adv	$11 - $106	12%
Community Health Plan Of Wa	$11 - $108	12%
Humana	$11 - $129	12%
Medicare (plans)	$11 - $106	12%
Molina Healthcare Of Washington	$11 - $108	12%
Molina Healthcare Of Washington Mcr Adv	$11 - $106	12%
UnitedHealthcare	$11 - $196	12%
Washington Coordinated Care	$11 - $131	12%
Community Health Plan Of Wa Mcd Rep	$12 - $105	13%
Medicaid / KanCare	$12 - $105	13%
Molina Healthcare Of Washington Mcd Rep	$13 - $113	14%
Blue Cross Blue Shield	$15 - $135	16%
Kaiser Foundation Health Plan Of The Northwest	$16 - $191	17%
First Choice Health Network	$17 - $157	18%
Cigna	$20 - $243	21%
Blue Shield Of Wa Regence	$49 - $122	51%

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 $76.
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 Snoqualmie Valley 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.