CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Marinhealth Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $542
Cash Discount Price: $571
vs. Medicare Baseline: 4.00x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Marinhealth Medical Center is $542. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $571. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 4.00x the Medicare baseline. Located in 250 Bon Air Road, Greenbrae, CA.

Cash / Self-Pay

$571

Average discount available for prompt cash payment at this facility.

Insurance Median

$542

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: $571 (421%)

Insurance Median: $542 (400%)

Cash: $571 (421% of Medicare)

Ins. Median: $542 (400% 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 400% of the Medicare baseline (a markup of 300%). 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
Aetna	$94	69%
Brown And Tolan	$94	69%
Healthnet Tailored Network	$94	69%
Kaiser	$94	69%
Marin Cancer Care	$94	69%
Ca Prison Health Care Services	$151	111%
Healthnet Enhancedcare	$245	181%
Provider Network Of America	$448	330%
Canopy	$542	400%
Canopy Hill Physicians	$542	400%
Blue Shield Cpic/Epo	$560	413%
Providers Network Of America	$594	438%
Blue Shield Hmo/Ppo	$622	459%
Hills Blue Shield Hmo/Ppo	$622	459%
Healthnet Hmo/Ppo	$629	464%
Healthnet Hmo/Ppo Hill Physicians	$629	464%
Blue Shield Aco	$644	475%
UnitedHealthcare	$2,330	1718%

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 $571.
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 Marinhealth Medical Center 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.