CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Atrium Health Navicent the Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $139
  • Cash Discount Price: $201
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Atrium Health Navicent the Medical Center is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $201. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.03x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.
Cash / Self-Pay
$201

Average discount available for prompt cash payment at this facility.

Insurance Median
$139

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: $201 (148%)
Insurance Median: $139 (103%)
Cash: $201 (148% of Medicare)
Ins. Median: $139 (103% 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
Aetna $91 - $404 67%
Blue Cross Blue Shield $91 - $350 67%
Georgia Health Advantage $91 - $119 67%
Humana $91 - $403 67%
UnitedHealthcare $91 - $128 67%
Multiplan $92 - $469 68%
Care Source $93 - $121 69%
Clover $93 - $121 69%
Eon Health $93 - $121 69%
Pruitt Health $96 - $119 71%
Alliant $110 - $258 81%
Beechstreet $114 - $545 84%
Ibg $114 - $414 84%
Novanet $114 - $469 84%
Three Rivers Provider Network $121 - $498 89%
Ambetter / Centene $123 - $299 91%
Cigna $139 - $386 103%
Kaiser $153 - $315 113%
Securehealth $155 - $205 114%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hemlock Street, Macon, GA 31201
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals