CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: HCA Florida Aventura Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $255
  • Cash Discount Price: $1,543
  • vs. Medicare Baseline: 1.88x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at HCA Florida Aventura Hospital is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,543. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.88x the Medicare baseline. Located in 20900 Biscayne Blvd, Aventura, FL.
Cash / Self-Pay
$1,543

Average discount available for prompt cash payment at this facility.

Insurance Median
$255

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: $1,543 (1138%)
Insurance Median: $255 (188%)
Cash: $1,543 (1138% of Medicare)
Ins. Median: $255 (188% 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
Blue Cross Blue Shield $30 - $357 22%
Aetna $32 - $466 24%
Freedom Health $40 - $249 29%
Optimum $40 - $134 29%
Simply Healthcare Plans $61 - $202 45%
Molina $80 - $420 59%
Corvel Corporation $91 - $194 67%
Careworks (Rockport) $93 - $198 69%
Prime Health $93 - $198 69%
Cigna $99 - $326 73%
Humana $99 - $528 73%
Health Sun Health Plan $100 - $331 74%
Aids Healthcare $103 - $1,865 76%
Mmm Of Fl (Health Advantage Plan) $108 - $357 80%
United Ppo $111 - $368 82%
Sunshine State Health Plan $122 - $404 90%
United $212 - $699 156%
Plotkin Health $235 - $777 173%
Prime Health Sherriff $235 - $777 173%
Medica Healthcare $273 - $901 201%
Multiplan $352 - $1,321 260%
Evernorth Bh $376 - $1,243 277%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 20900 Biscayne Blvd, Aventura, FL 33180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals