CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Porter-Starke Services Inc

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $76
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Porter-Starke Services Inc is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.56x the Medicare baseline. Located in 701 Wall St, Valparaiso, IN.
Cash / Self-Pay
$163

Average discount available for prompt cash payment at this facility.

Insurance Median
$76

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: $163 (120%)
Insurance Median: $76 (56%)
Cash: $163 (120% of Medicare)
Ins. Median: $76 (56% 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
Carelon $38 28%
United Behavioral Health $53 39%
UnitedHealthcare $53 - $76 39%
Ambetter / Centene $76 56%
Encore $76 56%
First Health $76 56%
Magellan $76 56%
Phcs/Multiplan $76 56%
Sagamore $76 56%
Cigna $78 58%
Humana $78 58%
Aetna $79 58%
Compsych $81 60%
Php $103 76%
Blue Cross Blue Shield $106 78%
Caresource Marketplace $120 88%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Wall St, Valparaiso, IN 46383
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Psychiatric