CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Caribou Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $252
  • Cash Discount Price: $192
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Caribou Medical Center is $252. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.86x the Medicare baseline. Located in 300 South 3Rd West, Soda Springs, ID.
Cash / Self-Pay
$192

Average discount available for prompt cash payment at this facility.

Insurance Median
$252

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: $192 (142%)
Insurance Median: $252 (186%)
Cash: $192 (142% of Medicare)
Ins. Median: $252 (186% 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
Select Health Mcr Adv $110 - $252 81%
Aetna $114 - $318 84%
Select Health-All Other Plans $121 - $318 89%
Bc Qualified Hp (Qhp) $125 - $302 92%
Blue Cross Blue Shield $125 - $318 92%
Select Health/Bright Path Mcr Adv $129 - $252 95%
Regence Blue Shield-All Other Plans $133 - $318 98%
Cigna $137 - $318 101%
Montana Health Co-Op-All Plans $140 - $318 103%
First Choice Health-All Plans $141 - $246 104%
Humana $146 - $252 108%
Pacific Source Mcr Adv $146 - $252 108%
Regence Blue Shield Mcr $146 - $252 108%
Pacific Source-All Other Plans $244 - $315 180%
UnitedHealthcare $246 - $315 181%
Deseret Healthcare-All Plans $260 - $308 192%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 South 3Rd West, Soda Springs, ID 83276
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals