Office visit, established patient (30-39 min)
Facility: St. Catherine Hospital - Garden City
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $93
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.69x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kaiser | $87 - $93 | 64% |
| Humana | $87 - $93 | 64% |
| Medicare (plans) | $87 - $93 | 64% |
| Blue Cross Blue Shield | $87 - $625 | 64% |
| Kansas Health | $87 | 64% |
| UnitedHealthcare | $87 - $93 | 64% |
| Cigna | $87 - $93 | 64% |
| Aetna | $87 - $93 | 64% |
| Innovage | $93 | 69% |
| Devoted Health | $93 | 69% |
Consumer Guidance & Cost Commentary
For CPT code 99214, representing an office visit with an established patient lasting 30 to 39 minutes, the negotiated rates at St. Catherine Hospital in Garden City, Kansas, range from $87 to $93 across ten major payers. This facility, a voluntary non-profit acute care hospital, charges $135.60 for Medicare, which serves as the benchmark for fair pricing. While the median negotiated rate is $93.00, the data indicates that cash payments could potentially be more cost-effective for patients with high-deductible plans, as the cash price is not explicitly listed but may fall below the insurance allowed amounts. It is important to note that while the facility is in-network for most major carriers, the specific rates vary by plan; for instance, Kaiser and Humana show a range of $87 to $93, whereas Blue Cross Blue Shield has a wider range of $87 to $625 across its four plans.
Patients should be aware that commercial negotiated rates often include administrative costs and can exceed the "true cost" represented by Medicare benchmarks, which typically reflect a markup of 120% to 150% of the federal rate. In this case, the Medicare amount of $135.60 provides a scientifically validated baseline to evaluate the facility's pricing, as commercial rates are frequently inflated compared to this standard. To minimize out-of-pocket expenses, consumers should proactively request a prompt-pay discount or self-pay rate before scheduling services, as these upfront discounts can bypass the higher administrative fees associated with insurance billing. Additionally, if a patient receives a bill that appears to include services not rendered or charges for bundled