Office visit, established patient (30-39 min)
Facility: Centura St. Catherine-Dodge City
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $89
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.66x 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 |
|---|---|---|
| Cigna | $89 | 66% |
| Humana | $89 | 66% |
| Kansas Health | $89 | 66% |
| Kaiser | $89 | 66% |
| Blue Cross Blue Shield | $89 - $222 | 66% |
| Aetna | $89 | 66% |
| Medicare (plans) | $89 | 66% |
Consumer Guidance & Cost Commentary
For CPT code 99214, representing an established patient office visit lasting 30 to 39 minutes, the negotiated rates at Centura St. Catherine-Dodge City in Dodge City, KS, range from $89 to $222 depending on the insurance plan. The lowest negotiated rate of $89 aligns with the median negotiated rate for this facility, while the highest rate of $222 applies to two Blue Cross Blue Shield plans. It is important to note that Kaiser's listed rate is an integrated-system internal rate and does not reflect a typical negotiated rate for out-of-network members. For patients with high-deductible plans, paying the cash price directly could sometimes be more affordable than the insurance negotiated rate, provided the facility offers a self-pay or prompt-pay discount. Patients should explicitly ask the hospital about these upfront payment options before scheduling to avoid unexpected costs.
The Medicare benchmark for this service is $135.60, which serves as a reliable baseline for evaluating commercial pricing. While the data does not provide specific county or state average comparisons for this exact code, the facility's lowest negotiated rate of $89 is below the Medicare amount, suggesting a competitive pricing structure relative to the federal baseline. Commercial rates often include administrative overhead that can inflate the price by 20% to 40% compared to the true cost of care reflected in Medicare benchmarks. To ensure you are not overcharged, review your itemized bill carefully for any unbundled codes or services not rendered, and dispute any errors in writing rather than accepting summary invoices. If you receive a balance bill from an out-of-network provider, you may have protections under the No Surprises Act that prevent you