CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Shands Jacksonville

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $227
  • Cash Discount Price: $158
  • vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Shands Jacksonville is $227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.67x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
$158

Average discount available for prompt cash payment at this facility.

Insurance Median
$227

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: $158 (117%)
Insurance Median: $227 (167%)
Cash: $158 (117% of Medicare)
Ins. Median: $227 (167% 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
UnitedHealthcare $45 - $407 33%
Aetna $69 - $467 51%
Wellcare Of Florida $86 - $170 63%
Florida Health Care Plan $109 - $283 80%
Devoted Health Plan $114 - $227 84%
Molina $114 - $397 84%
Simply Healthcare $114 - $227 84%
Volusia Health Network $120 - $238 88%
Northeast Florida State Hospital $126 - $249 93%
Amerihealth Caritas Florida $129 - $255 95%
Beacon Health Strategies $129 - $255 95%
Careplus Health Plan $129 - $255 95%
Positive Healthcare Partners $129 - $255 95%
Humana $134 - $482 99%
North Florida Evaluation & Treatment Center $134 - $266 99%
Capital Health Plan $143 - $283 105%
Community Care Plan $143 - $283 105%
Florida Complete Care $143 - $283 105%
Wellpath $143 - $283 105%
Blue Cross Blue Shield $145 - $412 107%
Centivo $157 - $312 116%
Disney Cruise Line $172 - $340 127%
Cigna $177 - $351 131%
Health First Health Plan $186 - $425 137%
Mental Health Associates $186 - $368 137%
Prime Health Services $200 - $425 147%
Florida Health Alliance $206 - $408 152%
Archbold Medical Center $214 - $425 158%
Genex $214 - $425 158%
Rockport Provider $214 - $425 158%
Corvel Corp $243 - $482 179%
First Health $243 - $482 179%
Florida Hospital Healthcare System $243 - $482 179%
Medsave Usa Tpa $243 - $482 179%
Fringe Benefits Coordinators $257 - $538 190%
Multiplan $257 - $510 190%
Novanet $257 - $510 190%
Ambetter / Centene $375 277%
Truli For Health $375 277%
Avmed $390 288%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals