CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: St Mary Medical Center Inc

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$181

about 1.3× the $136 Medicare rate · typically $102–$278

modeled estimate · not a bill or quote

What this hospital charges insurers

$159

Below the fair price — a good deal

about $22 under the fair price · 1.2× Medicare

Medicare pays $136 Fair price $181 This hospital $159 Cash price $946 Hospital's list price $1,576

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

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

Cheapest $47 Priciest $159

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

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Office visit, established patient (30-39 min) is about $181 (about 1.3× the $136 Medicare rate). St Mary Medical Center Inc charges insurers about $159, or about $946 in cash — below the fair price — a good deal. Located in Hobart, IN.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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	$161 - $180	119%
Blue Cross Blue Shieldmajor	$159 - $1,506	117%
Aetnamajor	$307 - $1,269	226%
Cignamajor	$221 - $902	163%
Humanamajor	$304 - $328	224%
Ambetter (Centene)	$162	119%
CareSource	$159	117%
+ 15 smaller / regional plans	$141 - $1,506

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 946), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99214.

Insurance Before you use insurance

Call your insurance company to confirm St Mary Medical Center Inc is in-network.
Ask your insurer whether prior approval is required for CPT code 99214.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Mary Medical Center Inc

Compare: Office visit, established patient (30-39 min) at other IN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.