CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Humboldt County Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $147
Cash Discount Price: $170
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Humboldt County Memorial Hospital is $147. 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 1.08x the Medicare baseline. Located in 1000 North 15Th Street, Humboldt, IA.

Cash / Self-Pay

$170

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $147 (108%)

Cash: $170 (125% of Medicare)

Ins. Median: $147 (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.

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
Great West	$122 - $132	90%
Aetna	$124 - $189	91%
Health Partners	$124 - $189	91%
Physicians Mutual	$126 - $136	93%
Cigna	$131 - $142	97%
Phcs	$131 - $142	97%
Blue Cross Blue Shield	$136 - $189	100%
Humana	$136 - $161	100%
Iowa Health	$136 - $189	100%
Molina	$136 - $189	100%
Deanhealth	$140 - $151	103%
UnitedHealthcare	$168 - $181	124%
Wellpoint	$168 - $189	124%
Iowa Total Care	$175 - $189	129%

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 $170.
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 Humboldt County Memorial 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.