CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: The East Alabama Healthcare Authority

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $110
  • Cash Discount Price: $73
  • vs. Medicare Baseline: 0.81x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at The East Alabama Healthcare Authority is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.81x the Medicare baseline. Located in 2000 Pepperell Parkway, Opelika, AL.
Cash / Self-Pay
$73

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $73 (54%)
Insurance Median: $110 (81%)
Cash: $73 (54% of Medicare)
Ins. Median: $110 (81% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Novanet $20 15%
Alabama Crime Victims $66 - $68 49%
Aetna $79 - $135 58%
Blue Cross Blue Shield $88 - $115 65%
Cigna $88 - $115 65%
Humana $88 - $115 65%
Simpra $88 - $115 65%
Viva $88 - $115 65%
Mcm Maxcare $105 - $108 77%
Mega Life $105 - $108 77%
UnitedHealthcare $105 - $108 77%
Beechstreet $111 - $115 82%
Coventry First Health $111 - $115 82%
Geha $111 - $115 82%
Multiplan $111 - $115 82%
Workers Comp $111 - $115 82%
Trpn $118 - $122 87%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Pepperell Parkway, Opelika, AL 36801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals