CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Perry County Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $217
  • Cash Discount Price: $246
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Perry County Memorial Hospital is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $246. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.60x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.
Cash / Self-Pay
$246

Average discount available for prompt cash payment at this facility.

Insurance Median
$217

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: $246 (181%)
Insurance Median: $217 (160%)
Cash: $246 (181% of Medicare)
Ins. Median: $217 (160% 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
Medicaid / KanCare $81 - $351 60%
Veterans Administration $88 - $351 65%
Bc 130 $91 - $280 67%
Group Insurance $91 - $351 67%
Medicare (plans) $91 67%
Workers Compensation $176 130%
Nsa $206 - $217 152%
Guarantor Liable $246 - $351 181%
Pcmh Insurnace $274 - $351 202%
Secondary Insurance $280 206%
UnitedHealthcare $280 206%
Operating Engineers $298 220%
Boilermakers Healthcare $305 225%
Cigna $305 225%
Great West $305 - $351 225%
Sagxxxx $305 225%
Champus $351 259%
Ngs American, Inc $351 259%
Patoka Valley $351 259%
Southwire $351 259%
Tricare $351 259%
Wausau Benefits $351 259%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8885 Sr 237, Tell City, IN 47586
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals