CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Davis County Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $29
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 0.21x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Davis County Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.21x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $170 (125%)
Insurance Median: $29 (21%)
Cash: $170 (125% of Medicare)
Ins. Median: $29 (21% 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 $16 12%
Amerigroup Mcr Adv-All Other Plans $17 13%
Choicecare Mcr Adv $17 13%
Home State Hlth Exch - All Other Plans $17 - $80 13%
Home State Hlth Mcr $17 13%
Mt Carmel Hp-All Plans $17 13%
Tricare $17 13%
American Hp Mcr Adv-All Plans $18 13%
Amerigroup Mcaid $19 - $207 14%
Home State Hlth Mcaid $19 - $201 14%
Iowa Total Care Mcaid-All Plans $19 - $205 14%
Molina Mcaid-All Plans $19 - $206 14%
Midlands Choice - All Plans $22 - $116 16%
Preferred Hlth Choices - All Plans $23 - $133 17%
Choicecare Comm - All Other Plans $29 - $121 21%
Blue Cross Blue Shield $138 102%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 North Madison Street, Bloomfield, IA 52537
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals