CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Gunnison Valley Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $236
Cash Discount Price: $244
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Gunnison Valley Hospital is $236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $244. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.74x the Medicare baseline. Located in 711 N Taylor St, Gunnison, CO.

Cash / Self-Pay

$244

Average discount available for prompt cash payment at this facility.

Insurance Median

$236

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: $244 (180%)

Insurance Median: $236 (174%)

Cash: $244 (180% of Medicare)

Ins. Median: $236 (174% 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.

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
Gunnison County Sheriff Op & Profee Only	$77 - $202	57%
Ebms Hdhp	$90 - $236	66%
Tetwp Op & Profee Only-All Plans	$90 - $236	66%
U Of Co Transplant-All Plans	$90 - $236	66%
Ebms Ppo Plan-All Other Plans	$105 - $276	77%
Medicaid / KanCare	$107 - $248	79%
Gunnison County Employees-All Other Plans	$120 - $315	88%
Scottish Rites-All Plans	$120 - $315	88%
Elap Employers-All Plans	$128 - $335	94%
Medicare (plans)	$130 - $165	96%
Blue Cross Blue Shield	$131 - $345	97%
Multiplan-All Plans	$135 - $355	100%
Gunnison County Coroner Op Only	$137 - $172	101%
Aetna	$138 - $323	102%
Rocky Mountain Health-All Plans	$142 - $374	105%
UnitedHealthcare	$142 - $374	105%
Cofinity-All Plans	$144 - $378	106%
Apostrophe-All Plans	$157 - $302	116%
Cigna	$157 - $329	116%
Occumed Op Only-All Plans	$262	193%

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 $244.
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 Gunnison Valley Hospital 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.