CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: HCA Florida Northwest Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $147
Cash Discount Price: $635
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at HCA Florida Northwest Hospital is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $635. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.08x the Medicare baseline. Located in 2801 N State Rd 7, Margate, FL.

Cash / Self-Pay

$635

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $635 (468%)

Insurance Median: $147 (108%)

Cash: $635 (468% of Medicare)

Ins. Median: $147 (108% 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	$37 - $356	27%
Blue Cross Blue Shield	$39 - $268	29%
Freedom Health	$46 - $190	34%
Optimum	$46	34%
Simply Healthcare Plans	$70	52%
Simply Healthcare	$86 - $160	63%
Corvel Corporation	$87 - $195	64%
Careworks (Rockport)	$89 - $199	66%
Prime Health	$89 - $199	66%
Molina	$102 - $320	75%
Oscar	$102 - $190	75%
Amerihealth Caritas	$108 - $202	80%
Cigna	$113	83%
Humana	$113 - $183	83%
Health Sun Health Plan	$115 - $253	85%
Mmm Of Fl (Health Advantage Plan)	$124	91%
United Ppo	$128 - $281	94%
Sunshine State Health Plan	$142 - $313	105%
Blis	$189 - $415	139%
United	$243 - $534	179%
Plotkin Health	$270 - $594	199%
Prime Health Sherriff	$270 - $594	199%
Medica Healthcare	$313	231%
Avmed	$318 - $594	235%
Multiplan	$404 - $1,009	298%

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 $635.
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 Northwest 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.