CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: HCA Florida St Petersburg Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $205
Cash Discount Price: $1,289
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at HCA Florida St Petersburg Hospital is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,289. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.51x the Medicare baseline. Located in 6500 38Th Ave N, Saint Petersburg, FL.

Cash / Self-Pay

$1,289

Average discount available for prompt cash payment at this facility.

Insurance Median

$205

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: $1,289 (951%)

Insurance Median: $205 (151%)

Cash: $1,289 (951% of Medicare)

Ins. Median: $205 (151% 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
Blue Cross Blue Shield	$56 - $271	41%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$60 - $61	44%
Corvel Corporation	$85 - $180	63%
Rockport Healthcare Group	$85 - $180	63%
Prime Health	$86 - $184	63%
Aetna	$88 - $389	65%
Access 2 Healthcare Physicians Freedom Health	$92 - $93	68%
Access 2 Healthcare Physicians Optimum	$92 - $93	68%
Freedom Health Care	$100 - $101	74%
Optimum Healthcare	$100 - $101	74%
Truli	$105 - $158	77%
Simply Healthcare	$197 - $200	145%
United	$210 - $583	155%
Cigna	$231 - $233	170%
Molina	$243 - $350	179%
Sunshine State Health Plan	$327 - $330	241%
Humana	$359 - $363	265%
Evolutions Healthcare Systems	$641 - $1,192	473%
Plotkin Health	$641 - $648	473%
Prime Health Sheriff	$641 - $648	473%
Multiplan	$961 - $1,101	709%

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 $1,289.
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 HCA Florida St Petersburg 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.