CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Washington County Hospital and Clinics

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $112
  • Cash Discount Price: $202
  • vs. Medicare Baseline: 0.83x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Washington County Hospital and Clinics is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.83x the Medicare baseline. Located in 400 East Polk Street, Washington, IA.
Cash / Self-Pay
$202

Average discount available for prompt cash payment at this facility.

Insurance Median
$112

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: $202 (149%)
Insurance Median: $112 (83%)
Cash: $202 (149% of Medicare)
Ins. Median: $112 (83% 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 $87 - $261 64%
Healthpartners Mcr Adv $87 - $110 64%
Med Assoc Mcr Adv $89 - $108 66%
Blue Cross Blue Shield $90 - $137 66%
Health Alliance Mcr Adv $91 - $108 67%
Humana $91 - $110 67%
Ia Total Care Wellcare Mcr Adv $91 - $111 67%
Wellpoint Mcr Adv Amerigrp - All Other Plans $91 - $111 67%
Molina Mcr Adv - All Other Plans $111 82%
Ia Total Care Mcaid $113 - $269 83%
Medicaid / KanCare $113 - $269 83%
Wellpoint Mcaid Amerigrp $113 - $269 83%
Med Assoc Hlth Choices Profee Only - All Otherplan $135 100%
Midlands Choice - All Plans $142 - $229 105%
Ambetter / Centene $157 116%
Health Alliance Comm - All Other Plans $160 - $256 118%
Healthpartners - All Other Plans $160 - $229 118%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 East Polk Street, Washington, IA 52353
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals