Office visit, established patient (30-39 min)
Facility: Overland Park Reg Med Ctr
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $366
- Cash Discount Price: $983
- vs. Medicare Baseline: 2.70x 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 270% of the Medicare baseline (a markup of 170%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $64 - $407 | 47% |
| Nhc Advantage | $93 - $336 | 69% |
| Healthyblue | $98 - $354 | 72% |
| Coventry | $108 - $711 | 80% |
| United | $123 - $795 | 91% |
| Aetna | $148 - $901 | 109% |
| Humana | $164 - $203 | 121% |
| Universal Healthcare | $172 - $619 | 127% |
| Coventry Kc Mo | $202 - $725 | 149% |
| College Park Family Care Center | $212 - $760 | 156% |
| Oha Network | $246 - $884 | 181% |
| Multiplan | $261 - $1,414 | 192% |
| Corvel Corporation | $320 - $1,149 | 236% |
| Focus Healthcare Mgmt, Inc | $369 - $1,326 | 272% |
| Triwest Health Alliance | $369 - $1,326 | 272% |
| Cco, Inc. | $369 - $1,326 | 272% |
Consumer Guidance & Cost Commentary
For this established patient office visit at Overland Park Reg Med Ctr, the cash price is $983.00, which matches the facility's median paid amount. While the facility is in-network for many payers, the negotiated rates vary significantly, ranging from $64 to $1,414 depending on the insurance plan. It is important to note that for patients with high-deductible plans, paying the cash price of $983.00 upfront can sometimes be cheaper than the insurance negotiated rate, especially for payers like Multiplan or Corvel Corporation where the allowed amount exceeds the cash price. Additionally, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can reduce the final cost.
The facility's pricing is evaluated against the Medicare benchmark of $135.60, which serves as the objective baseline for healthcare costs. The cash price of $983.00 represents a 2.7x markup compared to the Medicare rate, reflecting the administrative overhead and provider costs associated with commercial billing. While the facility is rated 4 stars and located in Overland Park, KS, patients should be aware that balance billing is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act. If a patient receives a bill exceeding the allowed amount, they should request an itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through formal written disputes.