CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Washakie Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99213
Insurance Median: $280
Cash Discount Price: $199
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Washakie Medical Center is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $199. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 2.94x the Medicare baseline. Located in 400 South 15Th Street, Worland, WY.

Cash / Self-Pay

$199

Average discount available for prompt cash payment at this facility.

Insurance Median

$280

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: $199 (209%)

Insurance Median: $280 (294%)

Cash: $199 (209% of Medicare)

Ins. Median: $280 (294% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 294% of the Medicare baseline (a markup of 194%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Banner Health	$103 - $267	108%
Humana	$103 - $267	108%
Medica	$103 - $529	108%
Triwest Healthcare Alliance Corp - Va Ccn	$103 - $267	108%
UnitedHealthcare	$103 - $511	108%
Interwest Health	$105 - $546	110%
Prime Health Services	$105 - $546	110%
Blue Cross Blue Shield	$204 - $529	214%
First Choice Health Network	$204 - $529	214%
Hue Health, Inc	$204 - $529	214%
Imagine Health, Llc (Wka Wise Provider Network)	$204 - $529	214%
Mountain Health Cooperative (Co-Op)	$204 - $529	214%
Coventry	$206 - $535	216%
Cigna	$209 - $540	220%
Multiplan	$209 - $540	220%

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 $199.
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 Washakie Medical Center 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.