CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Fayette County Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $169
  • Cash Discount Price: $245
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Fayette County Hospital is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $245. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.25x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.
Cash / Self-Pay
$245

Average discount available for prompt cash payment at this facility.

Insurance Median
$169

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: $245 (181%)
Insurance Median: $169 (125%)
Cash: $245 (181% of Medicare)
Ins. Median: $169 (125% 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 - $342 49%
Blue Cross Blue Shield $66 - $416 49%
Illinicare - All Plans $66 49%
Medicaid / KanCare $66 49%
Meridian-All Plans $66 49%
Health Alliance Mcare $78 - $300 58%
Healthlink Mcr Adv $78 - $300 58%
Humana $78 - $300 58%
Cigna $108 - $371 80%
Coventry/Ghp-All Plans $116 - $322 86%
UnitedHealthcare $131 - $411 97%
Healthlink Hmo $136 - $346 100%
Healthlink Ppo - All Other Plans $136 - $396 100%
Multiplan - All Plans $159 - $421 117%
Health Alliance - All Other Plans $172 - $409 127%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 650 W Taylor St, Vandalia, IL 62471
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals