CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Larkin Community Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $155
  • Cash Discount Price: $192
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Larkin Community Hospital is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.14x the Medicare baseline. Located in 7031 Sw 62Nd Ave, South Miami, FL.
Cash / Self-Pay
$192

Average discount available for prompt cash payment at this facility.

Insurance Median
$155

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: $192 (142%)
Insurance Median: $155 (114%)
Cash: $192 (142% of Medicare)
Ins. Median: $155 (114% 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
Cigna $26 - $122 19%
Healthsun-All Plans $32 - $1,700 24%
Humana $32 - $750 24%
Medicaid / KanCare $32 - $487 24%
Star Network-All Plans $42 - $195 31%
Jmh Health Plan Hmo/Ppo-All Other Plans $58 - $750 43%
Global Excel-All Plans $63 - $292 46%
Haa Preferred Partners-All Plans $63 - $292 46%
Medicare (plans) $74 - $511 55%
UnitedHealthcare $75 - $711 55%
Molina Exch Marketplace-All Other Plans $92 68%
Corvel Mcare Workers Comp-All Plans $94 - $438 69%
Blue Cross Blue Shield $97 - $9,184 72%
Aetna $102 - $487 75%
Fci-All Plans $102 - $117 75%
Florida Comm Care Mcare-All Other Plans $102 75%
Ops Maritime-All Plans $102 75%
Opus Hospice Ip Only-All Plans $102 75%
Preferred Care Partners Mcare-All Plans $102 75%
Avmed-All Plans $105 - $487 77%
Careplus Health-All Other Plans $105 - $487 77%
Centurion-All Plans $105 - $487 77%
Coventry Comml-All Plans $105 - $487 77%
Doctors Healthcare-All Plans $105 - $487 77%
First Med Hp Of Fl-All Plans $105 - $487 77%
Florida Health Solution/Hmo-All Plans $105 - $1,400 77%
Clear Springs Hlth-All Plans $107 79%
Unicare Simply Mcare Ppo-All Plans $107 79%
Jipa Network-All Plans $108 - $317 80%
Wellpath-All Plans $112 83%
Fdc-All Plans $117 86%
Bright Health-All Other Plans $126 - $584 93%
Allianz (Azga)-All Plans $132 97%
United Prop Casualty-All Plans $155 - $462 114%
Oscar Health-All Plans $210 - $974 155%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7031 Sw 62Nd Ave, South Miami, FL 33143
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals