CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Sarasota Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $197
  • Cash Discount Price: $174
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Sarasota Memorial Hospital is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.45x the Medicare baseline. Located in 1700 S Tamiami Trl, Sarasota, FL.
Cash / Self-Pay
$174

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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: $174 (128%)
Insurance Median: $197 (145%)
Cash: $174 (128% of Medicare)
Ins. Median: $197 (145% 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
Simply Healthcare Oncology $56 41%
Sunshine State Oncology $56 41%
Molina Oncology $58 43%
Amerihealth Caritas Oncology $59 44%
Community Care Plan Oncology $59 44%
Florida Community Care Oncology $71 - $154 52%
Blue Cross Blue Shield $93 - $374 69%
Wellcare Oncology $103 - $134 76%
Simply Freedom Optimum Oncology $104 - $134 77%
UnitedHealthcare $110 - $412 81%
Aetna $114 - $438 84%
Careworks $197 145%
Enlyte $197 145%
Oscar Oncology $210 155%
Avmed $237 - $400 175%
Ambetter / Centene $257 - $337 190%
Usa Managed Care $259 - $438 191%
First Health $269 - $455 198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 S Tamiami Trl, Sarasota, FL 34239
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals