CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: UW Health

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $132
  • Cash Discount Price: $44
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at UW Health is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.97x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.
Cash / Self-Pay
$44

Average discount available for prompt cash payment at this facility.

Insurance Median
$132

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: $44 (32%)
Insurance Median: $132 (97%)
Cash: $44 (32% of Medicare)
Ins. Median: $132 (97% 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
Aetna $66 - $132 49%
Blue Cross Blue Shield $66 - $134 49%
Medicaid / KanCare $66 49%
Humana $86 - $132 63%
Medicare (plans) $86 - $146 63%
Mychoice Wi Medical Adv $86 - $132 63%
UnitedHealthcare $86 - $167 63%
Ecoh $136 - $203 100%
Hfn $136 - $203 100%
Wps $138 102%
Quartz Fully Insured $145 - $189 107%
Cigna $146 - $191 108%
Alliance Premier Network $150 - $196 111%
Quartz Aso $151 - $197 111%
The Alliance $155 - $202 114%
Workers Comp $156 115%
Beloit Healt System $160 118%
Mercy Care $193 142%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 East State Street, Rockford, IL 61104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals