CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Jefferson County Health Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $206
  • Cash Discount Price: $167
  • vs. Medicare Baseline: 1.52x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Jefferson County Health Center is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.52x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$167

Average discount available for prompt cash payment at this facility.

Insurance Median
$206

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: $167 (123%)
Insurance Median: $206 (152%)
Cash: $167 (123% of Medicare)
Ins. Median: $206 (152% 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
UnitedHealthcare $78 - $521 58%
Tricare $89 - $225 66%
Amerigroup Mcr Adv $92 - $232 68%
Humana $92 - $232 68%
Iowa Total Care Comm - All Other Plans $92 - $232 68%
Iowa Total Care Mcr $92 - $232 68%
Molina Mcr Adv $92 - $232 68%
Iowa Total Care Mcaid $96 - $243 71%
Molina Mcaid/Chip $96 - $243 71%
Medicaid / KanCare $98 - $248 72%
Aetna $112 - $521 83%
Medicare (plans) $112 - $284 83%
Midlands New Product $188 - $475 139%
Coventry Commercial Hmo $195 - $492 144%
Coventry Commercial Ppo - All Other Plans $206 - $521 152%
Midlands Choice-All Other Plans $206 - $521 152%
Molina Marketplace - All Other Plans $229 - $579 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals