CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Boone Memorial Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$63
about 0.7× the $95 Medicare rate · typically $41–$104
modeled estimate · not a bill or quote
What this hospital charges insurers
$47
Below the fair price — a good deal
about $16 under the fair price · 0.5× Medicare
Medicare pays $95 Fair price $63 This hospital $47 Cash price $69 Hospital's list price $101

How we calculate the fair BaseRate →

How this hospital compares to other WV hospitals

Lowest price of the 9 WV hospitals we have prices for — a strong deal.

Cheapest $47 Priciest $58

Black dot = this hospital, among the 9 WV hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $63 (about 0.7× the $95 Medicare rate). Boone Memorial Hospital charges insurers about $47, or about $69 in cash — below the fair price — a good deal. Located in Madison, WV.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana UnitedHealthcareKaiser 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
Blue Cross Blue Shieldmajor $27 - $66 28%
Aetnamajor $27 - $192 28%
Cignamajor $37 - $151 39%
Humanamajor $26 - $65 27%
Government programs also on file: Medicare, Medicaid.

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Facility Profile & Credentials

  • Address: 701 Madison Avenue, Madison, WV 25130
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals