CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Cherokee Regional Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $120
  • Cash Discount Price: $285
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Cherokee Regional Medical Center is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.88x the Medicare baseline. Located in 300 Sioux Valley Drive, Cherokee, IA.
Cash / Self-Pay
$285

Average discount available for prompt cash payment at this facility.

Insurance Median
$120

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: $285 (210%)
Insurance Median: $120 (88%)
Cash: $285 (210% of Medicare)
Ins. Median: $120 (88% 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
Health Partners $38 - $317 28%
Molina $40 - $317 29%
Admin Concepts $72 - $317 53%
Aetna $72 - $317 53%
American Republic $72 - $317 53%
Apw $72 - $317 53%
Auxiant $72 - $317 53%
Avera $72 - $317 53%
Bankers Life $72 - $317 53%
Blue Cross Blue Shield $72 - $317 53%
Champus $72 - $317 53%
Cigna $72 - $317 53%
Humana $72 - $317 53%
Iowa Total Care $72 - $317 53%
Liability $72 - $317 53%
Meridian $72 - $317 53%
Meritain $72 - $317 53%
Midlands $72 - $317 53%
Mutual Of Omaha $72 - $317 53%
Occunet $72 - $317 53%
Physicians Mutual $72 - $317 53%
Private Healthcare $72 - $317 53%
Sanford $72 - $317 53%
United American $72 - $317 53%
UnitedHealthcare $72 - $317 53%
Wellpoint $72 - $317 53%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Sioux Valley Drive, Cherokee, IA 51012
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals