CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Deaconess Illinois Crossroads

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $122
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Deaconess Illinois Crossroads is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.90x the Medicare baseline. Located in 8 Doctors Park Rd, Mount Vernon, IL.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $87 (64%)
Insurance Median: $122 (90%)
Cash: $87 (64% of Medicare)
Ins. Median: $122 (90% 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 - $196 49%
Blue Cross Blue Shield $66 - $122 49%
Meridian Health Plan $66 - $122 49%
Molina Healthcare Of Illinois $66 - $123 49%
Wellcare $66 - $122 49%
Healthlink $77 - $83 57%
Self-Pay $87 64%
Humana $92 - $193 68%
Mytru Advantage $92 - $122 68%
Umwa $92 - $122 68%
UnitedHealthcare $92 - $122 68%
Cigna $96 71%
Deaconess Onecare $99 73%
Care Improvement Plus $124 91%
Alliance Coal $126 - $201 93%
Alter-Net Medical Services, Inc. $146 - $347 108%
Noncontracted $146 - $195 108%
Prime Health Services $186 137%
Guardian Resources, Inc. $208 153%
Healthcare'S Finest Network (Hfn) $211 156%
Medicalcontrol Network Solutions $211 156%
National Provider Network $211 156%
Three Rivers Provider Network $216 159%
Beech Street $218 161%
Hope Trust $347 256%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8 Doctors Park Rd, Mount Vernon, IL 62864
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals