CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Memorial Hospital and Manor

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $247
  • Cash Discount Price: $203
  • vs. Medicare Baseline: 1.82x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Memorial Hospital and Manor is $247. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $203. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.82x the Medicare baseline. Located in 1500 E Shotwell Street, Bainbridge, GA.
Cash / Self-Pay
$203

Average discount available for prompt cash payment at this facility.

Insurance Median
$247

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: $203 (150%)
Insurance Median: $247 (182%)
Cash: $203 (150% of Medicare)
Ins. Median: $247 (182% 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
Medicare (plans) $93 69%
Amerigroup_Plan $185 - $214 136%
Medicaid / KanCare $185 - $214 136%
Peach_State_Health_Plan_Plan $185 - $214 136%
Caresource_Plan $194 - $225 143%
Blue Cross Blue Shield $227 - $263 167%
Humana $229 - $272 169%
Aetna $232 - $306 171%
Uhc_Plan $232 - $269 171%
Novanet_Plan $235 - $272 173%
Cigna $244 - $282 180%
Private_Healthcare_Systems_Plan $250 - $289 184%
Multiplan_Plan $265 - $306 195%
Corvel_Plan $279 - $323 206%
Tnga_Plan $450 332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 E Shotwell Street, Bainbridge, GA 39819
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals