CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: HCA Florida North Florida Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $225
  • Cash Discount Price: $653
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at HCA Florida North Florida Hospital is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $653. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.66x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.
Cash / Self-Pay
$653

Average discount available for prompt cash payment at this facility.

Insurance Median
$225

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: $653 (482%)
Insurance Median: $225 (166%)
Cash: $653 (482% of Medicare)
Ins. Median: $225 (166% 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 - $482 22%
Aetna $31 - $573 23%
United $67 - $860 49%
Simply $69 - $294 51%
Cigna $78 - $795 58%
Corvel Corporation $85 - $188 63%
Molina Healthcare $85 - $612 63%
Prime Health $86 - $192 63%
Careworks (Rockport Community) $89 - $198 66%
Humana $90 - $382 66%
Sunshine State Health Plan $115 - $487 85%
Avmed $225 - $956 166%
Plotkin Health $225 - $956 166%
Prime Health Sheriff $225 - $956 166%
Corizon Phs $270 - $1,147 199%
Multiplan $351 - $1,624 259%
Evernorth $360 - $1,529 265%
Evolutions Healthcare $382 - $1,624 282%
Ppo Next $382 - $1,624 282%
Novanet $405 - $1,720 299%
Beacon Health Options $450 - $1,911 332%
American Health Plan $15,000 11062%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6500 W Newberry Rd, Gainesville, FL 32605
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals