CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Community First Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $197
  • Cash Discount Price: $345
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Community First Medical Center is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.45x the Medicare baseline. Located in 5645 W Addison Street, Chicago, IL.
Cash / Self-Pay
$345

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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: $345 (254%)
Insurance Median: $197 (145%)
Cash: $345 (254% of Medicare)
Ins. Median: $197 (145% 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
Beacon Mcr Op Only - All Other Plans $91 67%
Blue Cross Blue Shield $91 - $235 67%
Harmony Mcr Adv - All Other Plans $91 67%
Humana $91 67%
Meridian Mcr Adv - All Other Plans $91 67%
Molina Marketplace - All Other Plans $91 67%
Molina Mcr Adv $91 67%
Zing Hlth Mcr Adv - All Plans $91 67%
Aetna $207 - $689 153%
Cigna $218 - $345 161%
UnitedHealthcare $435 321%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5645 W Addison Street, Chicago, IL 60634
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals