CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Holmes Regional Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $157
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Holmes Regional Medical Center is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.16x the Medicare baseline. Located in 1350 S Hickory St, Melbourne, FL.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$157

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: $70 (52%)
Insurance Median: $157 (116%)
Cash: $70 (52% of Medicare)
Ins. Median: $157 (116% 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
Corizon Health $56 41%
UnitedHealthcare $79 - $281 58%
Health First Health Plan $82 - $126 60%
Florida Healthcare Plans $89 66%
Molina Healthcare $115 - $315 85%
Cigna $116 86%
Humana $118 - $281 87%
Aetna $121 - $309 89%
Amerigroup $121 - $295 89%
Sunshine Health Plan $121 - $295 89%
Disney Cruise Line $169 125%
Prime Heath Services, Inc. $211 156%
Multiplan $225 166%
Florida Blue $283 - $303 209%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1350 S Hickory St, Melbourne, FL 32901
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals