CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Baptist Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $163
Cash Discount Price: $51
vs. Medicare Baseline: 1.20x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Baptist Hospital is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.20x the Medicare baseline. Located in 123 Baptist Way, Pensacola, FL.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$163

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: $51 (38%)

Insurance Median: $163 (120%)

Cash: $51 (38% of Medicare)

Ins. Median: $163 (120% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$38 - $254	28%
Pensacola	$50 - $52	37%
Fl Blue	$70 - $139	52%
UnitedHealthcare	$84 - $92	62%
Hospice Regency	$100 - $104	74%
Bc Fl	$104 - $108	77%
Uwf Athletes	$123 - $226	91%
Cigna	$159 - $348	117%
Wc Corvel	$160 - $331	118%
Hospice Emerald Coast	$168 - $174	124%
Escambia	$201 - $209	148%
Private Healthcare	$218 - $226	161%
First Health	$233 - $242	172%
Choicecare	$251 - $261	185%
Mh Choicecare	$251 - $261	185%
Multiplan	$298 - $310	220%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $51.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Baptist Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.