CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Preston Memorial Hospital
Billing Code: 99213 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$72
about 0.8× the $95 Medicare rate · typically $41–$155
modeled estimate · not a bill or quote
Medicare pays $95 Fair price $72 Cash price $27 Hospital's list price $54
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
5 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 | $32 - $175 | 34% |
| Blue Cross Blue Shieldmajor | $39 - $172 | 41% |
| Aetnamajor | $32 - $175 | 34% |
| Cignamajor | $50 - $179 | 53% |
| Humanamajor | $32 - $117 | 34% |
| GEHA | $51 - $185 | 54% |
| UniCare | $103 | 108% |
| UPMC Health Plan | $34 - $123 | 36% |
| + 3 smaller / regional plans | $32 - $189 |
Government programs also on file: Medicare, Medicaid.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Preston Memorial Hospital
Compare: Office visit, established patient (20-29 min) at other WV hospitals
- Boone Memorial Hospital · Madison $47
- Vandalia Health Broaddus Hospital · Philippi $49
- Reynolds Memorial Hospital, Inc · Glen Dale $54
- Weirton Medical Center, Inc · Weirton $54
- Berkeley Medical Center · Martinsburg $55
- Mon Health Medical Center · Morgantown $57
- Wheeling Hospital, Inc · Wheeling $57
- Camc Greenbrier Valley Medical Center, Inc · Ronceverte $58
Insurance negotiated median for the same procedure, sorted lowest first.