CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Sarah Bush Lincoln Health Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $129
  • Cash Discount Price: $171
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Sarah Bush Lincoln Health Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.95x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$171

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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: $171 (126%)
Insurance Median: $129 (95%)
Cash: $171 (126% of Medicare)
Ins. Median: $129 (95% 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
Plain Church Mg-All Plans $60 - $76 44%
Mennonite-All Plans $68 - $86 50%
Aetna $86 - $172 63%
Bc Comm Mmai $86 63%
Beacon Health Options Behav-All Plans $86 63%
Hlth Alliance Mcr Adv $86 63%
Humana $86 - $87 63%
Meridian Mmai-All Other Plans $86 63%
Molina Mmai-All Other Plans $86 63%
Tricare $86 63%
UnitedHealthcare $86 - $159 63%
Va Ccn-All Plans $86 63%
Wellcare Med Adv-All Plans $86 63%
Bc Med Adv Ppo/Hmo $88 65%
Eiu Athlete-All Other Plans $105 - $134 77%
Healthscope-All Plans $111 - $141 82%
Rural King-All Plans $111 - $141 82%
Blue Cross Blue Shield $118 - $153 87%
Consociate-All Plans $120 - $153 88%
Hope Trust-All Plans $120 - $153 88%
Eiu Student $123 - $157 91%
Allied National-All Plans $126 - $160 93%
Companion Life-All Plans $126 - $160 93%
Hlth Alliance-All Other Plans $126 - $160 93%
First Health-All Plans $128 - $162 94%
Innovative Hlthware-All Plans $128 - $162 94%
Healthlink Hmo $129 - $164 95%
Healthlink Ppo - All Other Plans $129 - $164 95%
Multiplan-All Plans $129 - $164 95%
Cigna $135 - $172 100%
Cphp-All Plans $135 - $172 100%
Beech Street-All Plans $138 - $176 102%
Hfn-All Plans $138 - $176 102%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals