CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Chatuge Regional Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $176
Cash Discount Price: $210
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Chatuge Regional Hospital is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.30x the Medicare baseline. Located in 110 S Main Street, Hiawassee, GA.

Cash / Self-Pay

$210

Average discount available for prompt cash payment at this facility.

Insurance Median

$176

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: $210 (155%)

Insurance Median: $176 (130%)

Cash: $210 (155% of Medicare)

Ins. Median: $176 (130% 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
Amerigroup Community Care	$77	57%
UnitedHealthcare	$80 - $300	59%
Aetna	$124 - $374	91%
Blue Cross Blue Shield	$140 - $290	103%
Cigna	$140 - $308	103%
Humana	$140 - $154	103%
Wellcare	$210 - $231	155%
Caresource Network Partners, Llc.	$214 - $235	158%
Alliant Health Plan	$280 - $308	206%

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 $210.
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 Chatuge Regional 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.