CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Halifax Health Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $125
  • Cash Discount Price: $178
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Halifax Health Medical Center is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.92x the Medicare baseline. Located in 303 N Clyde Morris Blvd, Daytona Beach, FL.
Cash / Self-Pay
$178

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $178 (131%)
Insurance Median: $125 (92%)
Cash: $178 (131% of Medicare)
Ins. Median: $125 (92% 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
Embs $41 - $228 30%
Aetna $46 - $281 34%
Florida Healthcare - Hecn $50 - $92 37%
Sunshine State Health Plan $51 - $94 38%
Blue Cross Blue Shield $57 - $118 42%
Avmed $67 - $134 49%
Coventry $68 - $169 50%
UnitedHealthcare $68 - $161 50%
Centivo $72 - $134 53%
County Of Volusia Corrections $72 - $134 53%
Independent Living Systems $72 - $281 53%
A&G Admin $74 - $137 55%
Volusia County Employee $74 - $137 55%
Claimdoc $87 - $161 64%
Devoted Health $87 - $161 64%
Employers Health Network $87 - $161 64%
Oscar $87 - $161 64%
Prime Health Services $87 - $161 64%
Volusia $87 - $188 64%
Sim Plan Pay $94 - $174 69%
Hrgi $102 - $188 75%
Plotkin Consulting $102 - $188 75%
Evolutions International $109 - $201 80%
Summit America $116 - $214 86%
Division Of The Blind $125 92%
Americas Choice Provider Network $130 - $268 96%
Integrated Health Plan $130 - $241 96%
Multiplan $130 - $241 96%
Three Rivers $138 - $255 102%
Simply Healthcare Plans $152 - $281 112%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 N Clyde Morris Blvd, Daytona Beach, FL 32114
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals