CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Boone County Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $137
  • Cash Discount Price: $204
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Boone County Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $204. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.01x the Medicare baseline. Located in 1015 Union Street, Boone, IA.
Cash / Self-Pay
$204

Average discount available for prompt cash payment at this facility.

Insurance Median
$137

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: $204 (150%)
Insurance Median: $137 (101%)
Cash: $204 (150% of Medicare)
Ins. Median: $137 (101% 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
Amerigroup Mcr Adv - All Other Plans $42 - $137 31%
Choice Care Mcr Adv - All Plans $42 - $136 31%
Humana $42 - $297 31%
Iowa Hlth Adv - All Plans $42 - $136 31%
Mt Carmel Hp - All Plans $42 - $136 31%
UnitedHealthcare $42 - $194 31%
Va Ccn-All Plans $42 - $136 31%
Aetna $43 - $258 32%
Meridian Mcaid - All Plans $46 - $330 34%
Iowa Total Care Mcaid - All Plans $47 - $337 35%
Medicaid / KanCare $47 - $340 35%
Tricare $61 - $132 45%
Healthsmart Accell Network $71 - $231 52%
Medical Associates Hp-All Plans $76 - $248 56%
Healthsmart Ppo - All Other Plans $82 - $264 60%
Health Alliance-All Plans $92 - $297 68%
Midlands Choice-All Plans $94 - $304 69%
Mutually Preferred-All Plans $97 - $314 72%
Health Partners Profee Only - All Plans $135 100%
Wellmark Hmo $137 101%
Wellmark Ppo - All Other Plans $137 101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1015 Union Street, Boone, IA 50036
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals