Mason General Hospital & Family of Clinics

SheltonMason CountyCritical Access Hospitals

New patient visit (45 min)

Quality: 2 of 5 (CMS overall rating)Earliest available date: call (360) 426-1611

What you may pay

With insurance from an employer or private plan
$204 – $413At least one plan lists 2 separate amounts for this procedure. They may be parts of one bill that you pay together (for example the hospital’s fee and the fee of the doctor who reads a scan) or alternatives (inpatient or outpatient). We don’t show one price or compare it until we can tell which; every line is listed below. Ask the hospital which lines apply to you.
Paying yourself (cash price)
$320 – $356The hospital lists 2 separate amounts for this procedure. They may be parts of one bill that you pay together (for example the hospital’s fee and the fee of the doctor who reads a scan) or alternatives (inpatient or outpatient). We don’t show one price or compare it until we can tell which; every line is listed below. Ask the hospital which lines apply to you.

These are prices the hospital published, not a quote. With insurance you usually pay part of the rate (your deductible and coinsurance); the estimator on the procedure page works it out. A higher price does not mean better care.

Doctors usually bill separately. At most hospitals these are the hospital’s own charges. The surgeon, radiologist, anesthesiologist or pathologist usually sends a separate bill: ask each of them for an estimate too.

Source: Mason General Hospital & Family of Clinics’s own price file. CareNavIQ last refreshed prices on 2026-11-09.

Next step: ask the hospital for a Good Faith Estimate for this procedure (phone number above).

28 published prices, grouped by who each price applies to.

Cash price 2 prices

The hospital's discounted price for patients paying without insurance.

Cash price prices for New patient visit (45 min) at Mason General Hospital & Family of Clinics
PricePart of the billHospital’s descriptionHow it’s setSettingSource date
$320Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutes—Inpatient or outpatient—
$356Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutes—Inpatient or outpatient—

List price (before discounts) 2 prices

The hospital's full chargemaster price. Few patients pay this amount.

List price (before discounts) prices for New patient visit (45 min) at Mason General Hospital & Family of Clinics
PricePart of the billHospital’s descriptionHow it’s setSettingSource date
$427Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutes—Inpatient or outpatient—
$474Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutes—Inpatient or outpatient—

Commercial insurance 10 prices

Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Commercial insurance prices for New patient visit (45 min) at Mason General Hospital & Family of Clinics
PayerPlanPricePart of the billHospital’s descriptionHow it’s setSettingSource date
AetnaCommercial$244Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
AetnaCommercial$244Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
AetnaCommercial$408Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
AetnaCommercial$408Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
KaiserCommercial$204Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
KaiserCommercial$204Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
MolinaCommercial$404Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
MolinaCommercial$404Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
MolinaCommercial$413Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
MolinaCommercial$413Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—

Medicare Advantage 14 prices

Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Medicare Advantage prices for New patient visit (45 min) at Mason General Hospital & Family of Clinics
PayerPlanPricePart of the billHospital’s descriptionHow it’s setSettingSource date
AetnaMedicare Advantage$492Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
AetnaMedicare Advantage$492Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
Blue Cross Blue ShieldMedicare Advantage$421Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
Blue Cross Blue ShieldMedicare Advantage$421Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
Blue Cross Blue ShieldMedicare Advantage$425Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
Blue Cross Blue ShieldMedicare Advantage$425Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
HumanaMedicare Advantage$419Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
HumanaMedicare Advantage$419Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
HumanaMedicare Advantage$454Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
HumanaMedicare Advantage$454Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
KaiserMedicare Advantage$222Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—
KaiserMedicare Advantage$222Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
Mutual of OmahaMedicare Advantage$655Hospital’s fee99204 Office/Outpatient Visit - New Level 4 45-59 Minutesfee scheduleInpatient or outpatient—
Mutual of OmahaMedicare Advantage$655Hospital’s feeGlobal OB Office Visit Level 4 New 99204 45-29 Minutesfee scheduleInpatient or outpatient—

Doctors here who do this procedure

91 doctors affiliated with Mason General Hospital & Family of Clinics billed Traditional Medicare for New patient visit (45 min) in 2024, most Medicare services first. See all doctors and practices, including those with no hospital affiliation.

Doctors affiliated with Mason General Hospital & Family of Clinics who billed Traditional Medicare for New patient visit (45 min)
Doctor or practicePracticeMedicare quality scoreTimes billed to Traditional Medicare (2024)Traditional Medicare amount for their own service (2024)
Haroon Yousaf, MDInterventional Cardiology · OlympiaGrays Harbor County Public Hospital District No 1Group of 63 cliniciansNot rated412$164 in the office (no hospital amount)
Patrick Murray, MDUrology · OlympiaCapital Medical Center Specialty Physicians LLCGroup of 99 cliniciansNot rated297$162 in the office (no hospital amount)
Peter Park, DOPhysical Medicine And Rehabilitation · OlympiaOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 clinicians89 of 100CMS MIPS 2024, reported by their group245$163 in the office (no hospital amount)
Ryan Halpin, MDNeurosurgery · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated214$164 in the office (no hospital amount)
Kaley Capitano, DOFamily Practice · OlympiaOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 clinicians89 of 100CMS MIPS 2024, reported by their group171$160 in the office (no hospital amount)
Sung-Won Kim, MDOtolaryngology · OlympiaEar Nose And Throat Associates Southwest Inc PSGroup of 6 clinicians75 of 100CMS MIPS 2024, reported by their group162$162 in the office (no hospital amount)
Terra Grandmason, ARNPNurse Practitioner · OlympiaPuget Sound Gastroenterology PLLCGroup of 61 cliniciansNot rated152$140 in the office (no hospital amount)
Marshall Mccabe, DOGastroenterology · OlympiaOlympia Multi Specialty ClinicGroup of 21 cliniciansNot rated125$165 in the office (no hospital amount)
Michelle Thompson, DOGastroenterology · OlympiaOlympia Multi Specialty ClinicGroup of 21 cliniciansNot rated120$163 in the office (no hospital amount)
Madeleine ReedNurse Practitioner · OlympiaPuget Sound Gastroenterology PLLCGroup of 61 cliniciansNot rated118$140 in the office (no hospital amount)
Roger Chan, MDCardiovascular Disease (Cardiology) · OlympiaLewis County Hospital District No 1Group of 28 cliniciansNot rated117$164 in the office (no hospital amount)
Kaley Myer, MDDermatology · OlympiaDermatology And Allergy SpecialistsGroup of 6 clinicians86 of 100CMS MIPS 2024108$163 in the office (no hospital amount)
Sara Wasilenko, DOVascular Surgery · OlympiaMulticare Health SystemGroup of 2,325 cliniciansNot rated108$164 in the office (no hospital amount)
John Kuczynski, MDGastroenterology · OlympiaOlympia Multi Specialty ClinicGroup of 21 cliniciansNot rated107$163 in the office (no hospital amount)
Melissa Bluestein-Rogers, FNP-CNurse Practitioner · OlympiaPuget Sound Gastroenterology PLLCGroup of 61 cliniciansNot rated107$138 in the office (no hospital amount)
Daniel Brown, MDUrology · OlympiaIndependent practice87 of 100CMS MIPS 2024105$172 in the office (no hospital amount)
Alvaro Lucioni, MDUrology · SeattleOffers telehealth visitsVirginia Mason Medical CenterGroup of 867 cliniciansNot rated100$140 at a hospital or surgery center
Bonnie Mcreynolds, ARNPNurse Practitioner · ElmaPuget Sound Gastroenterology PLLCGroup of 61 cliniciansNot rated99$139 in the office (no hospital amount)
Christopher Spikes, PA-CPhysician Assistant · LakewoodOlympia Orthopaedic Associates PLLCGroup of 87 clinicians89 of 100CMS MIPS 2024, reported by their group93$143 in the office (no hospital amount)
Hillary Hatcher, ACNP-BCNurse Practitioner · OlympiaOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 clinicians89 of 100CMS MIPS 2024, reported by their group93$140 in the office (no hospital amount)
Warangkhana Wongba, MDPulmonary Disease · OlympiaOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated93$166 in the office (no hospital amount)
David Elkins, PAPhysician Assistant · OlympiaOffers telehealth visitsCapital Medical Center Specialty Physicians LLCGroup of 99 cliniciansNot rated92$145 in the office (no hospital amount)
Richard Redman, MDPulmonary Disease · OlympiaOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated92$165 in the office (no hospital amount)
Richard Mclaughlin, MDOrthopedic Surgery · SeattleOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated91$166 in the office (no hospital amount)
Ralph Jay Pulido, MSN, ARNP, FNP-CNurse Practitioner · OlympiaPuget Sound Gastroenterology PLLCGroup of 61 cliniciansNot rated89$141 in the office (no hospital amount)
Darrelle Walker, ARNP, FNP-CNurse Practitioner · OlympiaPuget Sound Gastroenterology PLLCGroup of 61 cliniciansNot rated86$140 in the office (no hospital amount)
Ahmad Fora, MDHematology/Oncology · OlympiaAmerican Oncology Partners PAGroup of 391 cliniciansNot rated79$164 in the office (no hospital amount)
Sara Martinez, MD, PHDCardiovascular Disease (Cardiology) · OlympiaProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated77$164 in the office (no hospital amount)
Zhongzeng Li, MDNeurology · OlympiaProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated74$164 in the office (no hospital amount)
Anam Akmal, MDEndocrinology · LaceyOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated73$162 in the office (no hospital amount)
David Nesheim, MDCritical Care (Intensivists) · OlympiaProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated73$165 in the office (no hospital amount)
Cody Franzen, MDSports Medicine · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated70$166 in the office (no hospital amount)
Peter Wood, MDOrthopedic Surgery · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated69$166 in the office (no hospital amount)
Gopal Ghimire, MD, PHD, MRCPInterventional Cardiology · OlympiaProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated68$166 in the office (no hospital amount)
Andrea Cigliola, PA-CPhysician Assistant · OlympiaDermatology And Allergy SpecialistsGroup of 6 clinicians89 of 100CMS MIPS 202464$142 in the office (no hospital amount)
Raul Manuel Cruz, MDPulmonary Disease · OlympiaOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated63$164 in the office (no hospital amount)
Brianne Noel, PA-CPhysician Assistant · SeattleOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated58$140 in the office (no hospital amount)
Suchit Khanijao, MDPulmonary Disease · OlympiaOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated57$164 in the office (no hospital amount)
Chad Bender, MDOrthopedic Surgery · CentraliaOlympia Orthopaedic Associates PLLCGroup of 87 clinicians86 of 100CMS MIPS 202454$164 in the office (no hospital amount)
Gregory Byrd, MDHand Surgery · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated53$153 in the office (no hospital amount)
Omar Gonzalez, PA-CPhysician Assistant · RentonOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 clinicians89 of 100CMS MIPS 2024, reported by their group53$141 in the office (no hospital amount)
Amy Smith, PA-CPhysician Assistant · OlympiaOffers telehealth visitsCapital Medical Center Specialty Physicians LLCGroup of 99 clinicians87 of 100CMS MIPS 2024, reported by their group52$144 in the office (no hospital amount)
Stephanie Romine, ARNPNurse Practitioner · OlympiaPuget Sound Gastroenterology PLLCGroup of 61 cliniciansNot rated52$139 in the office (no hospital amount)
Christine Hammer, MDNeurosurgery · TacomaOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated49$155 in the office (no hospital amount)
Russell Leong, DONephrology · OlympiaOffers telehealth visitsMemorial Nephrology Associates PLLCGroup of 9 cliniciansNot rated49$166 in the office (no hospital amount)
Charles Rossow, MD, PHDCardiovascular Disease (Cardiology) · TacomaMulticare Health SystemGroup of 2,325 cliniciansNot rated46$166 in the office (no hospital amount)
Elizabeth Trythall, ARNPNurse Practitioner · SeattleOffers telehealth visitsThe Association Of University PhysiciansGroup of 3,535 clinicians94 of 100CMS MIPS 2024, reported by their care program (APM)46$115 at a hospital or surgery center
Natasha Arora, MDCardiovascular Disease (Cardiology) · OlympiaOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated46$166 in the office (no hospital amount)
Curtis Reinke, MDInternal Medicine · OlympiaIndependent practiceNot rated45$130 at a hospital or surgery center
Charles Hillenbrand, MDGeneral Surgery · OlympiaMulticare Health SystemGroup of 2,325 cliniciansNot rated44$160 in the office (no hospital amount)
Jordan Mulder, DOOtolaryngology · OlympiaOffers telehealth visitsCapital Medical Center Specialty Physicians LLCGroup of 99 cliniciansNot rated44$156 in the office (no hospital amount)
Paige Workman, PA-CPhysician Assistant · OlympiaOlympic Dermatology And Laser Clinic P SGroup of 6 clinicians90 of 100CMS MIPS 2024, reported by their group44$145 in the office (no hospital amount)
Richard Lamour, MDOrthopedic Surgery · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated43$160 in the office (no hospital amount)
Suzanne MagannPhysician Assistant · OlympiaOlympic Dermatology And Laser Clinic P SGroup of 6 clinicians90 of 100CMS MIPS 2024, reported by their group42$140 in the office (no hospital amount)
Trevor Barronian, MDOrthopedic Surgery · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated42$169 in the office (no hospital amount)
Kyle PinePhysician Assistant · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated41$141 in the office (no hospital amount)
David Brown, MDSports Medicine · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated36$167 in the office (no hospital amount)
Deborah Oldfield, PA-CPhysician Assistant · TacomaOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated36$142 in the office (no hospital amount)
Yiting LiInternal Medicine · OlympiaPuget Sound Gastroenterology PLLCGroup of 61 clinicians80 of 100CMS MIPS 2024, reported by their group35$163 in the office (no hospital amount)
Jerome Zechmann, MDOrthopedic Surgery · OlympiaOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated33$166 in the office (no hospital amount)
Frederick Albrecht, MD PHDNephrology · BremertonOffers telehealth visitsNephrology Associates Of Kitsap County PLLCGroup of 3 clinicians95 of 100CMS MIPS 202432$165 in the office (no hospital amount)
Andrew Manista, MDOrthopedic Surgery · OlympiaOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated28$166 in the office (no hospital amount)
Maria Ramneantu, MDNeurology · OlympiaOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated28$166 in the office (no hospital amount)
Katie Pauley, ARNPNurse Practitioner · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated27$144 in the office (no hospital amount)
Benjamin Matthews, ARNPNurse Practitioner · OlympiaSilver Falls Dermatology LLCGroup of 101 clinicians100 of 100CMS MIPS 202424$137 in the office (no hospital amount)
Brad Howard, DOCardiovascular Disease (Cardiology) · OlympiaProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated24$166 in the office (no hospital amount)
Jonathan Clemons, PA-CPhysician Assistant · TacomaNot on file89 of 100CMS MIPS 2024, reported by their group24$141 in the office (no hospital amount)
Richard Kennedy, MDCardiovascular Disease (Cardiology) · OlympiaMulticare Health SystemGroup of 2,325 cliniciansNot rated24$166 in the office (no hospital amount)
Angela HaroldPhysician Assistant · OlympiaOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated23$139 in the office (no hospital amount)
Daniel Katz, DOFamily Practice · OlympiaIndependent practiceNot rated23$166 in the office (no hospital amount)
Kaitlin Bock, ARNPNurse Practitioner · ChehalisOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated22$141 in the office (no hospital amount)
Jennifer Winter, PA-CPhysician Assistant · OlympiaDermatology And Allergy SpecialistsGroup of 6 clinicians89 of 100CMS MIPS 202421$147 in the office (no hospital amount)
Maren Zaro, ARNPNurse Practitioner · TacomaSkokomish Tribal CouncilGroup of 4 cliniciansNot rated21$141 in the office (no hospital amount)
Marina Berndt, MDFamily Practice · OlympiaOffers telehealth visitsProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated21$166 in the office (no hospital amount)
Noeru Okamura, DOFamily Practice · OlympiaCapital Medical Center Physicians LLCGroup of 59 cliniciansNot rated21$155 in the office (no hospital amount)
Terri Grosshans, PA-CPhysician Assistant · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated21$139 in the office (no hospital amount)
Mark Layton, MDRheumatology · OlympiaIndependent practice23 of 100CMS MIPS 202419$157 in the office (no hospital amount)
Natallia Tsesliukevich, MDInternal Medicine · OlympiaOffers telehealth visitsCapital Medical Center Physicians LLCGroup of 59 cliniciansNot rated19$166 in the office (no hospital amount)
Yuxuan Hu, MDCardiovascular Disease (Cardiology) · OlympiaProvidence Health And Services WashingtonGroup of 475 cliniciansNot rated18$166 in the office (no hospital amount)
Nicholas Weber, MDGastroenterology · OlympiaPuget Sound Gastroenterology PLLCGroup of 61 cliniciansNot rated17$159 in the office (no hospital amount)
Charles Anderegg, PACPhysician Assistant · SheltonOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated16$144 in the office (no hospital amount)
Meimin Xie, MDGastroenterology · OlympiaPuget Sound Gastroenterology PLLCGroup of 61 cliniciansNot rated16$166 in the office (no hospital amount)
Robert Widrow, MDInternal Medicine · OlympiaIndependent practice71 of 100CMS MIPS 202416$160 in the office (no hospital amount)
Steven Johns, PA-CPhysician Assistant · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 clinicians94 of 100CMS MIPS 202416$144 in the office (no hospital amount)
Robert Mckay, MDOrthopedic Surgery · OlympiaOffers telehealth visitsOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated15$166 in the office (no hospital amount)
Bradley Christ, MDOrthopedic Surgery · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated14$166 in the office (no hospital amount)
Joseph Ye, MD, PHDHematology/Oncology · OlympiaAmerican Oncology Partners PAGroup of 391 cliniciansNot rated14$166 in the office (no hospital amount)
Jared Cornelison, PA-CPhysician Assistant · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 clinicians89 of 100CMS MIPS 2024, reported by their group13$143 in the office (no hospital amount)
Shane Son, MDFamily Practice · OlympiaOffers telehealth visitsIndependent practiceNot rated13$167 in the office (no hospital amount)
Hanan Batarseh, MDNephrology · OlympiaYakima Valley Memorial PhysiciansGroup of 391 cliniciansNot rated12$163 in the office (no hospital amount)
Jamie Schroff, PA-CPhysician Assistant · OlympiaOlympia Orthopaedic Associates PLLCGroup of 87 cliniciansNot rated11$141 in the office (no hospital amount)

Reading the doctor list

  • A higher price doesn’t mean better care. The quality score and the price come from different CMS files and are shown separately on purpose.
  • The amount is what Traditional Medicare (original Medicare) approved for the doctor’s or lab’s own service: Medicare’s payment plus the patient’s share. It is not what commercial insurance or Medicare Advantage pays, and the hospital or surgery center bills separately (surgery centers aren’t in this list).
  • The Medicare quality score is CMS’s MIPS final score (0 to 100), based mostly on the doctor’s Medicare patients. About half of doctors aren’t scored, so Not rated says nothing bad about a doctor. A group’s score covers everyone in the group.
  • CMS doesn’t publish counts under 11 patients, so doctors who rarely bill Medicare for this aren’t listed, and No price published means CMS has no amount for that setting.
  • Medicare’s file doesn’t say where a doctor did the procedure, only that they billed it in Washington. Affiliations are the hospitals each doctor lists with Medicare.

See a price that looks wrong? Tell us about it.