CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Spanish Peaks Regional Health Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $195
  • Cash Discount Price: $212
  • vs. Medicare Baseline: 1.44x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Spanish Peaks Regional Health Center is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $212. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.44x the Medicare baseline. Located in 23500 Us Highway 160, Walsenburg, CO.
Cash / Self-Pay
$212

Average discount available for prompt cash payment at this facility.

Insurance Median
$195

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: $212 (156%)
Insurance Median: $195 (144%)
Cash: $212 (156% of Medicare)
Ins. Median: $195 (144% 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
Devoted Health Mcr - All Plans $76 - $315 56%
UnitedHealthcare $89 - $202 66%
Blue Cross Blue Shield $106 - $195 78%
Apostrophe - All Plans $111 - $195 82%
Cofinity - All Plans $111 - $200 82%
Connect For Health - All Plans $111 - $202 82%
Friday Hp Chp - All Plans $111 - $195 82%
Prov Ntwrk Of America - All Plans $119 - $195 88%
Rmhp - All Plans $128 - $202 94%
Kaiser Ppo - All Other Plans $149 - $195 110%
Cigna $195 - $228 144%
Multiplan Phcs - All Plans $206 - $228 152%
Kaiser Ppo Mcr $217 160%
Beacon Health Op Only-All Plans $253 187%
Humana $300 221%
Medicare (plans) $300 221%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 23500 Us Highway 160, Walsenburg, CO 81089
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals