Office visit, established patient (30-39 min)
Facility: University Of Kansas Hospital
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $509
- Cash Discount Price: $483
- vs. Medicare Baseline: 3.75x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 375% of the Medicare baseline (a markup of 275%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| UnitedHealthcare | $308 - $909 | 227% |
| Aetna | $308 | 227% |
| Workers Comp [503999901] | $308 - $909 | 227% |
| Medicare (plans) | $308 - $315 | 227% |
| Lasso Healthcare [503999926] | $308 | 227% |
| Tricare | $308 | 227% |
| Devoted [503200068] | $308 | 227% |
| Humana | $308 - $315 | 227% |
| Ku Athletics [503200094] | $308 | 227% |
| Triwest [503201703] | $308 | 227% |
| Allwell [503200078] | $318 | 235% |
| Blue Cross Blue Shield | $318 - $661 | 235% |
| American Health Plans [503200968] | $324 | 239% |
| Centurion [5032000966] | $401 | 296% |
| Ambetter / Centene | $524 | 386% |
| Oscar [503201609] | $586 | 432% |
| Wellfit [503301514] | $586 | 432% |
| Centivo [5032000982] | $586 | 432% |
| 6 Degrees Health [503999050] | $601 - $771 | 443% |
| Alt Wppa [5032000964] | $617 | 455% |
| Occunet [503999930] | $648 | 478% |
| Fort Hays State Student Athletes [5032000960] | $648 | 478% |
| Claimdoc [503301509] | $833 | 614% |
| Multiplan [503200057] | $833 | 614% |
| Medica [503200074] | $909 | 670% |
| Geha [503200036] | $909 | 670% |
| Advanced Medical Pricing Solutions [503301513] | $925 | 682% |
Consumer Guidance & Cost Commentary
For this established patient office visit at University Of Kansas Hospital, the negotiated rates across 27 payers range from $308 to $925, with a median negotiated amount of $509. This commercial rate is significantly higher than the Medicare benchmark of $135.60, reflecting the typical administrative markup inherent in insurance contracts. While the facility's cash median price of $483 is lower than the negotiated average, patients with high-deductible plans should be aware that paying out-of-pocket might result in lower costs if their insurance allowed amount exceeds the cash price. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final bill by bypassing the administrative costs associated with insurance claims processing.
The facility is located in Kansas City, KS (ZIP 66160), and operates as an acute care hospital owned by a government hospital district. While the provided data does not include explicit state or county average comparisons for this specific CPT code, the wide variance in payer rates—from $308 for some plans up to $925 for others—highlights the importance of verifying your specific plan's allowed amount before scheduling. To avoid unexpected balance billing, patients should ensure they are receiving care from an in-network provider, as the No Surprises Act protects against out-of-network charges for emergency services at in-network facilities. If you receive a bill that seems inconsistent with the negotiated rates, you have the right to request a formal itemized audit to identify any errors, unbundled codes, or services not rendered, which is the most effective way to reduce medical debt.