CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Banner Boswell Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $212
  • Cash Discount Price: $104
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Banner Boswell Medical Center is $212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.56x the Medicare baseline. Located in 13632 N 99Th Ave, Sun City, AZ.
Cash / Self-Pay
$104

Average discount available for prompt cash payment at this facility.

Insurance Median
$212

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: $104 (77%)
Insurance Median: $212 (156%)
Cash: $104 (77% of Medicare)
Ins. Median: $212 (156% 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
Arizona Physicians Ipa $55 41%
Banner University Health Plan $55 41%
Health Choice Arizona, Inc. $55 - $215 41%
Mercy Care $55 41%
Aetna $86 - $227 63%
Hospice Of The Valley $150 111%
Arizona Priority Care $172 127%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $194 143%
Plotkin Health $194 143%
UnitedHealthcare $209 - $230 154%
Oscar Health Plan $215 159%
Quiktrip Corporation $232 171%
Cigna $283 - $295 209%
Provider Network Of America $322 237%
Arizona Medical Network $344 254%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13632 N 99Th Ave, Sun City, AZ 85351
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals