CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Cleveland Clinic Martin North Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $102
  • Cash Discount Price: $450
  • vs. Medicare Baseline: 0.75x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Cleveland Clinic Martin North Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $450. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.75x the Medicare baseline. Located in 200 Se Hospital Ave, Stuart, FL.
Cash / Self-Pay
$450

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $450 (332%)
Insurance Median: $102 (75%)
Cash: $450 (332% of Medicare)
Ins. Median: $102 (75% 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
Aetna $45 - $743 33%
Freedom Health $53 - $102 39%
Amerihealth $55 41%
Miami Childrens Health Plan $56 - $97 41%
Molina $56 41%
Sunshine Health $56 41%
Blue Cross Blue Shield $58 - $97 43%
Cigna $58 - $113 43%
Independent Living Systems $64 - $102 47%
Avmed $65 - $145 48%
United $97 - $119 72%
Careplus $102 75%
Clear Spring Health $105 - $137 77%
Bmi $119 88%
Multiplan $131 - $146 97%
Clarity Health $141 - $537 104%
The Legacy Companies $141 - $537 104%
Consociate Health $519 - $620 383%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Se Hospital Ave, Stuart, FL 34994
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals