CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Seattle Children's Hospital
Billing Code: 99213 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$120
about 1.3× the $95 Medicare rate · typically $49–$154
modeled estimate · not a bill or quote
Medicare pays $95 Fair price $120 Cash price $135 Hospital's list price $135
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
6 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 | $36 - $124 | 38% |
| Blue Cross Blue Shieldmajor | $36 - $164 | 38% |
| Aetnamajor | $113 - $164 | 119% |
| Cignamajor | $115 - $136 | 121% |
| Humanamajor | $128 - $164 | 134% |
| Kaiser Permanentemajor | $35 - $139 | 37% |
| Medical Mutual | $128 - $164 | 134% |
| Moda Health | $113 - $164 | 119% |
| Molina | $35 - $103 | 37% |
| PacificSource | $130 | 137% |
| Providence Health Plan | $115 - $138 | 121% |
| SelectHealth | $128 - $164 | 134% |
| Tufts Health Plan | $115 - $136 | 121% |
| + 61 smaller / regional plans | $34 - $164 |
Government programs also on file: Medicaid.
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Seattle Children's Hospital
Compare: Office visit, established patient (20-29 min) at other WA hospitals
- Arbor Health Morton Hospital · Morton $48
- Mary Bridge Children's Hospital · Tacoma $50
- Shriners Hospital for Children · Spokane $58
- Lake Chelan Community Hospital · Chelan $65
- Newport Community Hospital · Newport $66
- Forks Community Hospital · Forks $67
- Trios Health · Kennewick $68
- Valley Medical Center · Renton $69
Insurance negotiated median for the same procedure, sorted lowest first.