CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Southeast Iowa Regional Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $146
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Southeast Iowa Regional Medical Center is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.08x the Medicare baseline. Located in 1221 South Gear Avenue, West Burlington, IA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$146

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%)
Insurance Median: $146 (108%)
Ins. Median: $146 (108% 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
Medicaid / KanCare $49 - $67 36%
United Behavioral Health Ma $77 57%
United Behavioral Health Rn $77 - $97 57%
Aetna $86 - $199 63%
United Behavioral Health Phd $88 65%
American Healthplan Of Iowa - Midlevel $99 73%
Plain Church $101 - $217 74%
United Behavioral Health Md $103 - $114 76%
Humana $120 88%
Absolute Solutions $140 - $202 103%
American Healthplan Of Iowa - Md $140 103%
First Agency $140 - $202 103%
Multiplan $140 - $202 103%
Henderson County $147 - $213 108%
Elap $162 - $231 119%
Blue Cross Blue Shield $183 135%
Wellpoint (Amerigroup) $187 138%
Midlands Choice $188 - $301 139%
UnitedHealthcare $193 142%
Immugrun $210 155%
Brighton Amish Church $217 160%
6 Degree $267 197%
Geha $311 229%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1221 South Gear Avenue, West Burlington, IA 52655
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals