CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Pulaski Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $148
  • Cash Discount Price: $299
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Pulaski Memorial Hospital is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $299. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.09x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.
Cash / Self-Pay
$299

Average discount available for prompt cash payment at this facility.

Insurance Median
$148

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: $299 (221%)
Insurance Median: $148 (109%)
Cash: $299 (221% of Medicare)
Ins. Median: $148 (109% 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
Humana $57 - $385 42%
Blue Cross Blue Shield $67 - $479 49%
Cigna $67 - $455 49%
Sagamore - All Other Plans $67 - $362 49%
Sagamore Rose Acre $67 - $357 49%
UnitedHealthcare $75 - $479 55%
Ambetter / Centene $81 - $148 60%
Caresource Mcaid Hip $81 - $148 60%
Cenpatico Mcaid Hip $81 - $148 60%
Mhs Mcaid Hip $81 - $148 60%
Multiplan - All Plans $81 - $431 60%
Caresource Mcaid Hhw $89 - $479 66%
Cenpatico Mcaid Hhw - All Other Plans $89 - $479 66%
Mhs Mcaid Hhw/Hcc $89 - $479 66%
Mdwise Mcaid Hcc $90 - $479 66%
Mdwise Mcaid Hhw $90 - $479 66%
Mdwise Mcaid Hip - All Other Plans $90 - $148 66%
Encore Ppo - All Other Plans $97 - $407 72%
Caresource Exch Hmo Hix - All Other Plans $101 - $186 74%
Encore Workers Comp $130 - $431 96%
Caresource Mcare Hmo $132 - $148 97%
Mhs Mcare Allwell $134 - $150 99%
Aetna $154 - $172 114%
Community Health Alliance - All Plans $162 - $426 119%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 616 E 13Th St, Winamac, IN 46996
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals