CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Baptist Hospital of Miami

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $133
  • Cash Discount Price: $270
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Baptist Hospital of Miami is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $270. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.98x the Medicare baseline. Located in 8900 N Kendall Dr, Miami, FL.
Cash / Self-Pay
$270

Average discount available for prompt cash payment at this facility.

Insurance Median
$133

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: $270 (199%)
Insurance Median: $133 (98%)
Cash: $270 (199% of Medicare)
Ins. Median: $133 (98% 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
Avmed $16 - $377 12%
UnitedHealthcare $20 - $767 15%
Non Contracted $23 - $281 17%
Aetna $24 - $614 18%
Cigna $24 - $614 18%
Blue Cross Blue Shield $26 - $497 19%
Amerihealth $28 - $345 21%
International $41 - $499 30%
Dimension Health Plan $47 - $690 35%
Affordable $54 - $652 40%
Phcs $57 - $690 42%
Quality Health $57 - $690 42%
Sunshine State $74 55%
Vista $173 128%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8900 N Kendall Dr, Miami, FL 33176
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals