CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Kossuth Regional Health Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $201
  • Cash Discount Price: $191
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Kossuth Regional Health Center is $201. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.48x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.
Cash / Self-Pay
$191

Average discount available for prompt cash payment at this facility.

Insurance Median
$201

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: $191 (141%)
Insurance Median: $201 (148%)
Cash: $191 (141% of Medicare)
Ins. Median: $201 (148% 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
Va Ccn - All Plans $80 - $98 59%
Mercy One - All Plans $84 - $98 62%
Humana $99 - $193 73%
Amerigroup Mcr Adv - All Other Plans $100 74%
UnitedHealthcare $101 - $215 74%
Medical Associates - All Plans $133 - $218 98%
Preferred Health - All Plans $133 - $218 98%
Blue Cross Blue Shield $137 101%
Midlands Choice - All Plans $145 - $180 107%
Health Partners New Bus - All Other Plans $180 - $183 133%
Health Partners Exisiting Bus $201 - $249 148%
Aetna $203 - $249 150%
Multiplan - All Plans $209 - $244 154%
Molina Mcaid/Chip - All Plans $226 - $265 167%
Amerigroup Mcaid $227 - $267 167%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1515 South Phillips Street, Algona, IA 50511
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals