CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: HCA Florida Raulerson Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $459
  • Cash Discount Price: $2,283
  • vs. Medicare Baseline: 3.38x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at HCA Florida Raulerson Hospital is $459. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,283. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 3.38x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.
Cash / Self-Pay
$2,283

Average discount available for prompt cash payment at this facility.

Insurance Median
$459

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: $2,283 (1684%)
Insurance Median: $459 (338%)
Cash: $2,283 (1684% of Medicare)
Ins. Median: $459 (338% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 338% of the Medicare baseline (a markup of 238%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Corvel Corporation $85 - $167 63%
Careworks (Rockport) $86 - $171 63%
Prime Health $86 - $171 63%
Blue Cross Blue Shield $144 - $550 106%
Aetna $158 - $685 117%
Optimum $196 145%
Oscar $434 320%
Health Sun Health Plan $486 358%
Simply Healthcare $536 395%
Sunshine State Health Plan $582 429%
Molina $616 454%
United Ppo $1,005 741%
United $1,027 757%
Avmed $1,142 842%
Plotkin Health $1,142 842%
Prime Health Sherriff $1,142 842%
Multiplan $1,712 - $1,941 1263%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1796 Hwy 441 North, Okeechobee, FL 34972
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals