CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Warner Hospital and Health Services

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $224
Cash Discount Price: $339
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Warner Hospital and Health Services is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $339. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.65x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$339

Average discount available for prompt cash payment at this facility.

Insurance Median

$224

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: $339 (250%)

Insurance Median: $224 (165%)

Cash: $339 (250% of Medicare)

Ins. Median: $224 (165% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$105 - $406	77%
Aetna	$108 - $352	80%
Health Alliance Med Adv	$108 - $170	80%
Humana	$108 - $352	80%
Molina Mcr/Mcd Dual	$108 - $170	80%
UnitedHealthcare	$108 - $352	80%
Wellcare Mcr Adv-All Plans	$108 - $170	80%
Healthlink Hmo	$205 - $323	151%
City Of Clinton (Employees Serv)-All Plans	$210 - $331	155%
Cigna	$218 - $344	161%
Caterpillar-All Plans	$224 - $352	165%
Multiplan Phcs-All Plans	$224 - $352	165%
Health Alliance-All Other Plans	$231 - $364	170%
Healthlink Ppo/Work Comp-All Other Plans	$231 - $364	170%
Consociate Care Ppo-All Plans	$237 - $373	175%
Hfn Ppo/Epo-All Plans	$237 - $373	175%
Three Rivers-All Plans	$250 - $393	184%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $339.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Warner Hospital and Health Services is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.