Office visit, established patient (30-39 min)
Facility: Labette Health
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $103
- Cash Discount Price: $108
- vs. Medicare Baseline: 0.76x 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 |
|---|---|---|
| Ambetter / Centene | $38 | 28% |
| Montgomery County | $51 - $147 | 38% |
| Medicaid / KanCare | $69 | 51% |
| Aetna | $85 | 63% |
| Kansas Superior Select | $92 | 68% |
| Multiplan | $131 | 97% |
| Choicecare (First Health Network) | $139 | 103% |
| Health Partners Of Kansas, Inc | $139 | 103% |
| Blue Cross Blue Shield | $189 | 139% |
| UnitedHealthcare | $193 | 142% |
Consumer Guidance & Cost Commentary
For this office visit at Labette Health in Parsons, KS, the cash price of $108.00 is notably lower than the facility's negotiated rates with most major payers, which range from $51 to $193. While the cash price is higher than the lowest negotiated rate offered by Ambetter / Centene ($38), it remains significantly below the rates charged to Medicaid / KanCare ($69), Aetna ($85), and Blue Cross Blue Shield ($189). This pricing structure highlights that for patients with high-deductible plans or those without insurance, paying cash directly can often be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the negotiated allowed amount exceeds the cash price.
It is important to note that the facility's cash rate of $108.00 is higher than the median negotiated rate of $103.00, suggesting that the cash price reflects a standard self-pay rate rather than a deep discount. Patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed. Additionally, while the facility is an in-network provider for most plans, the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, though patients should still request an itemized bill to ensure no unbundled charges or services not rendered are included in the final invoice.