Office visit, established patient (30-39 min)
Facility: Flagstaff Medical Center
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $312
- Cash Discount Price: $240
- vs. Medicare Baseline: 2.30x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 230% of the Medicare baseline (a markup of 130%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Carefirst | $30 | 22% |
| Mercy Care Rhba | $30 | 22% |
| Ahcccs | $31 | 23% |
| Ahcccs Other | $31 | 23% |
| Fmc Jail | $31 | 23% |
| Health Choice | $31 - $423 | 23% |
| Health Choice Arizona | $31 | 23% |
| Health Choice Integrated Care | $31 | 23% |
| Health Net Of Arizona | $31 | 23% |
| Mercy Care | $31 | 23% |
| Nhi Out Of State Ahcccs | $31 | 23% |
| UnitedHealthcare | $31 - $444 | 23% |
| University Of Arizona Health Plans | $33 - $131 | 24% |
| Va Pccc Triwest | $133 - $432 | 98% |
| Devoted | $144 | 106% |
| Naphcare | $233 | 172% |
| Pnoa | $240 | 177% |
| Self Pay | $240 - $480 | 177% |
| Self-Pay 50% Discount | $240 | 177% |
| Workers Comp | $312 | 230% |
| Blue Cross Blue Shield | $352 | 260% |
| Copperpoint | $352 | 260% |
| Aetna | $354 - $408 | 261% |
| Nau Athletic Department | $384 | 283% |
| Cigna | $432 | 319% |
| Fmc 90/10 | $432 | 319% |
| Rural Arizona Network Multiplan | $432 | 319% |
| Humana | $456 | 336% |
| Health Net Federal | $480 | 354% |
| United Behavioral Health | $480 | 354% |
| Auto Insurance | $5,000 | 3687% |