CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Kirby Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $136
  • Cash Discount Price: $264
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Kirby Medical Center is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.00x the Medicare baseline. Located in 1000 Medical Center Drive, Monticello, IL.
Cash / Self-Pay
$264

Average discount available for prompt cash payment at this facility.

Insurance Median
$136

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: $264 (195%)
Insurance Median: $136 (100%)
Cash: $264 (195% of Medicare)
Ins. Median: $136 (100% 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 $64 - $308 47%
Blue Cross Blue Shield $64 - $431 47%
Meridian $64 - $136 47%
UnitedHealthcare $65 - $303 48%
Molina $67 - $140 49%
Wellcare $86 - $136 63%
Zelis (Hfn) $107 - $396 79%
Catepillar, Inc. $116 - $374 86%
Humana $129 - $330 95%
Cigna $352 260%
Healthlink $354 - $526 261%
Multiplan/Phcs $354 - $526 261%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Medical Center Drive, Monticello, IL 61856
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals