CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Marshall Browning Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $101
Cash Discount Price: $144
vs. Medicare Baseline: 0.74x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Marshall Browning Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.74x the Medicare baseline. Located in 900 North Washington Street, Du Quoin, IL.

Cash / Self-Pay

$144

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $144 (106%)

Insurance Median: $101 (74%)

Cash: $144 (106% of Medicare)

Ins. Median: $101 (74% 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
Cigna	$58 - $153	43%
Aetna	$66 - $278	49%
Blue Cross Blue Shield	$66 - $278	49%
Meridian Hp Mcaid - All Plans	$66	49%
Molina Mcaid - All Plans	$66	49%
Health Alliance Mcr Adv	$70 - $278	52%
Humana	$70 - $278	52%
UnitedHealthcare	$70 - $278	52%
Wellcare Mcr Adv - All Plans	$70 - $278	52%
Healthlink Hmo - All Other Plans	$77 - $144	57%
Healthlink Ppo	$83 - $144	61%
Health Alliance - All Other Plans	$96 - $175	71%
Multiplan/Phcs - All Plans	$165 - $185	122%
Zelis - All Plans	$185	136%
Hope Trust - All Plans	$193 - $974	142%

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 $144.
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 Marshall Browning Hospital 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.