CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Baptist Medical Center - Nassau

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $425
  • Cash Discount Price: $536
  • vs. Medicare Baseline: 3.13x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Baptist Medical Center - Nassau is $425. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $536. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 3.13x the Medicare baseline. Located in 1250 S 18Th St, Fernandina Beach, FL.
Cash / Self-Pay
$536

Average discount available for prompt cash payment at this facility.

Insurance Median
$425

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: $536 (395%)
Insurance Median: $425 (313%)
Cash: $536 (395% of Medicare)
Ins. Median: $425 (313% 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 313% of the Medicare baseline (a markup of 213%). 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 $87 64%
Coventry Workers Comp $87 64%
Blue Cross Blue Shield $251 - $562 185%
Avmed $277 - $649 204%
Aetna $320 - $692 236%
Borland Groover $346 255%
Occunet $346 255%
Northeast Florida State Hospital $363 268%
Centivo $381 - $735 281%
Capital Health Plan $398 294%
UnitedHealthcare $398 - $425 294%
Geo Group $432 319%
Watchtower $476 351%
Fscj Student Insurance $519 383%
Savannah Grand Of Amelia Island $519 383%
Cigna $536 - $661 395%
Suddath Company $545 402%
Medicaid / KanCare $562 414%
Peach State Health Plan $562 414%
Phcs $649 479%
Evolutions Healthcare $778 574%
Multiplan $778 574%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1250 S 18Th St, Fernandina Beach, FL 32034
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals