CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Clay County Hospital

Billing Code: 99214 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$112
about 0.8× the $136 Medicare rate · typically $75–$278
modeled estimate · not a bill or quote
What this hospital charges insurers
$102
About the fair price
about $10 under the fair price · 0.8× Medicare
Medicare pays $136 Fair price $112 This hospital $102 Cash price $243 Hospital's list price $243

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $65 Priciest $102

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (30-39 min) is about $112 (about 0.8× the $136 Medicare rate). Clay County Hospital charges insurers about $102, or about $243 in cash — about the fair price. Located in Flora, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $66 - $194 49%
Blue Cross Blue Shieldmajor $102 - $178 75%
Aetnamajor $66 - $192 49%
Cignamajor $194 143%
Ambetter (Centene) $66 49%
HealthLink $158 - $194 117%
Medica $66 - $151 49%
Meridian $66 49%
WellCare $66 49%
+ 1 smaller / regional plan $231

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Facility Profile & Credentials

  • Address: 911 Stacy Burk Dr, Flora, IL 62839
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals