CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Grady Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $126
  • Cash Discount Price: $573
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Grady Memorial Hospital is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.93x the Medicare baseline. Located in 80 Jesse Hill, Jr Drive Se, Atlanta, GA.
Cash / Self-Pay
$573

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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: $573 (423%)
Insurance Median: $126 (93%)
Cash: $573 (423% of Medicare)
Ins. Median: $126 (93% 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
Ambetter / Centene $85 - $126 63%
Caresource $86 - $201 63%
Peach State $86 - $116 63%
Amerigroup $93 - $116 69%
Aetna $94 - $255 69%
Blue Cross Blue Shield $94 - $459 69%
Cigna $94 - $339 69%
Humana $94 - $126 69%
Kaiser $94 - $435 69%
Medicare (plans) $94 - $126 69%
UnitedHealthcare $94 - $413 69%
Vaccn $94 - $126 69%
Wellcare $94 - $126 69%
Clear Spring Health $99 - $132 73%
Clover $99 - $132 73%
Usp Naphcare $104 - $344 77%
Oscar Health $133 - $373 98%
Multiplan $441 325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 80 Jesse Hill, Jr Drive Se, Atlanta, GA 30303
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals