CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: HCA Florida Kendall Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $109
Cash Discount Price: $510
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at HCA Florida Kendall Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $510. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.80x the Medicare baseline. Located in 11750 Bird Rd, Miami, FL.

Cash / Self-Pay

$510

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $510 (376%)

Insurance Median: $109 (80%)

Cash: $510 (376% of Medicare)

Ins. Median: $109 (80% 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	$25 - $125	18%
Aetna	$33 - $163	24%
Freedom Health	$41 - $87	30%
Optimum	$41 - $47	30%
Simply Healthcare Plans	$62 - $71	46%
Molina	$90 - $147	66%
Corvel Corporation	$91 - $194	67%
Careworks (Rockport)	$93 - $198	69%
Prime Health	$93 - $198	69%
Cigna	$100 - $114	74%
Humana	$100 - $185	74%
Health Sun Health Plan	$101 - $116	74%
Aids Healthcare	$104 - $653	77%
Mmm Of Fl (Health Advantage Plan)	$109 - $125	80%
United Ppo	$113 - $129	83%
Sunshine State Health Plan	$124 - $141	91%
United	$214 - $245	158%
Plotkin Health	$238 - $272	176%
Prime Health Sherriff	$238 - $272	176%
Medica Healthcare	$276 - $316	204%
Multiplan	$356 - $462	263%
Evernorth Bh	$380 - $435	280%

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 $510.
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 Kendall 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.