CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Banner - University Medical Center Tucson Campus

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $455
Cash Discount Price: $836
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Banner - University Medical Center Tucson Campus is $455. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $836. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 3.36x the Medicare baseline. Located in 1625 North Campbell Avenue, Tucson, AZ.

Cash / Self-Pay

$836

Average discount available for prompt cash payment at this facility.

Insurance Median

$455

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: $836 (617%)

Insurance Median: $455 (336%)

Cash: $836 (617% of Medicare)

Ins. Median: $455 (336% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 336% of the Medicare baseline (a markup of 236%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $1,138	41%
Health Net	$55 - $1,228	41%
Mercy Care	$55	41%
Aetna	$56 - $1,199	41%
University Of Arizona (Kasser Medical Treatment Center)	$98 - $796	72%
Arizona Priority Care	$112 - $910	83%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$126 - $1,024	93%
Plotkin Health	$126 - $1,024	93%
Oscar Health Plan	$140 - $1,138	103%
Quiktrip Corporation	$151 - $1,228	111%
UnitedHealthcare	$161 - $817	119%
Cigna	$172 - $1,399	127%
Provider Network Of America	$210 - $1,706	155%
Arizona Medical Network	$224 - $1,820	165%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $836.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Banner - University Medical Center Tucson Campus is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.