CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Bluffton Regional Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $114
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 0.84x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Bluffton Regional Medical Center is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.84x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$114

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: $68 (50%)
Insurance Median: $114 (84%)
Cash: $68 (50% of Medicare)
Ins. Median: $114 (84% 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
Amish Aid $36 - $52 27%
Self Pay $36 - $119 27%
Physicians Health Plan $37 - $53 27%
Aetna $40 - $97 29%
Lutheran Preferred Network $45 - $174 33%
Cigna $48 - $77 35%
Php $48 - $69 35%
Php Freedom Network $48 - $68 35%
Php Management Systems $59 - $84 44%
Lutheran Trma $61 - $98 45%
UnitedHealthcare $71 - $102 52%
Encore Ppo $74 - $106 55%
Sagamore Sebt $78 - $111 58%
Sagamore Health Newtork Inc $81 - $116 60%
Consumer Life $94 - $135 69%
Ahg Dana Employees $99 - $141 73%
Bccp $104 77%
Align Networks $106 - $152 78%
Prime Health Services $114 - $163 84%
Private Healthcare Systems Inc $114 - $163 84%
Veterans Eval Services $118 87%
Multiplan $122 - $174 90%
Encore Health Network $125 - $195 92%
Advantage 360 $126 - $180 93%
Community Health Alliance $129 - $184 95%
First Health $131 - $187 97%
Allied Benefit Systems $137 - $195 101%
Cardinal Health Alliance $137 - $195 101%
Ppom $137 - $195 101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals