CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Memorial Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $203
  • Cash Discount Price: $338
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Memorial Medical Center is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $338. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.50x the Medicare baseline. Located in 701 N First St, Springfield, IL.
Cash / Self-Pay
$338

Average discount available for prompt cash payment at this facility.

Insurance Median
$203

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: $338 (249%)
Insurance Median: $203 (150%)
Cash: $338 (249% of Medicare)
Ins. Median: $203 (150% 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
Blue Cross Blue Shield $76 - $338 56%
Health Alliance $108 - $220 80%
Current Health Network Ppo $152 112%
Aetna $155 - $257 114%
Healthlink $169 - $213 125%
Commercial Workers Compensation $171 126%
Cigna $177 131%
Illinois Workers Compensation $180 133%
Phcs/Multiplan $183 - $203 135%
6 Degrees Health $203 150%
Hopetrust $203 150%
Hst $203 150%
Humana $203 150%
Magellan $203 150%
UnitedHealthcare $210 155%
Consociate $220 162%
Hfn $220 162%
Medicaid / KanCare $220 162%
Molina $224 165%
Preferred Plan $254 187%
Soi Mcfarland $254 187%
Soi Rushville $254 187%
Corvel $270 199%
Methodist First Choice $270 199%
Mutual Medical Plans $287 212%
Liability $338 249%
Medicare (plans) $338 249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N First St, Springfield, IL 62702
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals