CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Baptist Health Medical Center - Jacksonville

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $389
  • Cash Discount Price: $588
  • vs. Medicare Baseline: 2.87x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Baptist Health Medical Center - Jacksonville is $389. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $588. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 2.87x the Medicare baseline. Located in 800 Prudential Dr, Jacksonville, FL.
Cash / Self-Pay
$588

Average discount available for prompt cash payment at this facility.

Insurance Median
$389

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: $588 (434%)
Insurance Median: $389 (287%)
Cash: $588 (434% of Medicare)
Ins. Median: $389 (287% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 287% of the Medicare baseline (a markup of 187%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Corvel $39 - $87 29%
Coventry Workers Comp $39 - $87 29%
Non-Contracted $40 - $130 29%
Blue Cross Blue Shield $173 - $562 128%
Aetna $199 - $692 147%
UnitedHealthcare $208 153%
Avmed $277 - $450 204%
Cigna $337 - $528 249%
Borland Groover $346 255%
Occunet $346 - $432 255%
Northeast Florida State Hospital $363 - $407 268%
Centivo $381 - $735 281%
Capital Health Plan $398 294%
Innovative Healthware Services $407 300%
Geo Group $432 319%
Volusia Health Network $476 351%
Watchtower $476 351%
Fscj Student Insurance $519 383%
Suddath Company $545 402%
Caresource Of Georgia $562 414%
Medicaid / KanCare $562 414%
Peach State Health Plan $562 414%
Uf Health Proton Therapy Institute $606 447%
Phcs $649 - $692 479%
Evolutions Healthcare $778 574%
Multiplan $778 574%
Nemours Research $983 725%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Prudential Dr, Jacksonville, FL 32207
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals