Price Checker / CPT 99213
How much does Office visit — standard (established patient) cost?
CPT 99213 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is in line with what this normally costs. No need to dispute.
Fair price
$260–$300
What this should cost
With insurance
~$294,300
Typical out-of-pocket
Overcharged if over
$380
Push back above this
What hospitals charge for Office visit — standard (established patient)
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| PeaceHealth Ketchikan Medical Center KETCHIKAN, AK | $250 | — | 5914% |
| Phelps Health , MO | $1,075 | — | 2549% |
| Hoke Hospital , NC | $229 | — | 586% |
| UPMC Western Psychiatric , PA | $260 | $208 | 173% |
| Connally Memorial Health Centers - Main Campus Floresville, TX | $109 | — | 131% |
| Connally Memorial Health Centers - North Campus Floresville, TX | $109 | — | 98% |
| Connally Memorial Health Centers - La Vernia Campus Floresville, TX | $109 | — | 64% |
| Pine Rest Christian Mental Health Services GRAND RAPIDS, MI | $155 | $124 | 63% |
| Barnes-Kasson County Hospital SUSQUEHANNA, PA | $129 | $90 | 36% |
| Pathways Behavioral Health Services , TN | $115 | $115 | 21% |
| Molokai General Hospital KAUNAKAKAI, HI | $409 | — | 20% |
| Highland Springs LLC BEACHWOOD, OH | $100 | $950 | 5% |
| Henry Ford Brighton Center for Recovery Brighton, MI | — | — | -22% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Office visit — standard (established patient)
CPT code 99213 refers to office visit — standard (established patient) (billing description: "Office o/p est low 20 min"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $57 in a facility (hospital or surgery center) and $95 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.