CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: The Women's Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $103
Cash Discount Price: $87
vs. Medicare Baseline: 0.76x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at The Women's Hospital is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.76x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $87 (64%)

Insurance Median: $103 (76%)

Cash: $87 (64% of Medicare)

Ins. Median: $103 (76% 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
Aetna	$62 - $146	46%
Humana	$62 - $89	46%
Passport Molina Ky	$62	46%
UnitedHealthcare	$62 - $119	46%
Wellcare Ky	$62 - $89	46%
Blue Cross Blue Shield	$66 - $132	49%
Meridian Health Il	$66 - $89	49%
Molina Il	$66 - $89	49%
Amish	$87	64%
Self Pay	$87	64%
Caresource	$89	66%
Iu Health	$89	66%
Mhs	$89	66%
Molina Ky	$89	66%
Molina Ky Dual	$89	66%
One Care	$94	69%
Ambetter / Centene	$103	76%
Chamber Care	$104	77%
Patoka Valley Health Care (80/20 Plan)	$107	79%
Patoka Valley Health Care (90/10 Plan)	$107	79%
Immergrun	$108	80%
Caresource Marketplace (Just4Me)	$116	86%
Caresource Hip	$119	88%
Caresource In	$119	88%
Mdwise Hip	$119	88%
Mhs Behavioral	$119	88%
Hst	$120	88%
Alliance Coal	$123	91%
Allied National/Zelis - Freedom Plan	$125	92%
Claimdoc	$129	95%
Encorecombined	$139	103%
Encoreprime	$139	103%
Hope Trust	$143	105%
Noncontracted	$143	105%
Cigna	$146	108%
Claritev (Formerly Phcs/Mulitplan)	$146	108%
First Health/Coventry	$146	108%
Healthlink	$146	108%
Sagamore	$146	108%
Center Care	$149	110%

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 $87.
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 The Women's 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.