CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: HCA Florida Oak Hill Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $131
Cash Discount Price: $572
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at HCA Florida Oak Hill Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $572. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.97x the Medicare baseline. Located in 11375 Cortez Blvd, Brooksville, FL.

Cash / Self-Pay

$572

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $572 (422%)

Insurance Median: $131 (97%)

Cash: $572 (422% of Medicare)

Ins. Median: $131 (97% 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	$16 - $803	12%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$22 - $27	16%
Aetna	$33 - $1,198	24%
Access 2 Healthcare Physicians Freedom Health	$34 - $41	25%
Access 2 Healthcare Physicians Optimum	$34 - $41	25%
Freedom Health Care	$37 - $45	27%
Optimum Healthcare	$37 - $45	27%
Truli	$38 - $487	28%
Simply Healthcare	$73 - $507	54%
United	$78 - $1,798	58%
Cigna	$82 - $100	60%
Corvel Corporation	$85 - $180	63%
Rockport Healthcare Group	$85 - $180	63%
Prime Health	$86 - $184	63%
Molina	$90 - $154	66%
Sunshine State Health Plan	$121 - $1,019	89%
Humana	$132 - $160	97%
Plotkin Health	$236 - $1,997	174%
Prime Health Sheriff	$236 - $1,997	174%
Evolutions Healthcare Systems	$284 - $3,675	209%
Multiplan	$355 - $3,396	262%
Oscar	$599	442%

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 $572.
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 Oak Hill 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.