Office visit, established patient (30-39 min)
Facility: Menorah Medical Center
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $550
- Cash Discount Price: $1,711
- vs. Medicare Baseline: 4.06x 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 406% of the Medicare baseline (a markup of 306%). 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 | $58 - $550 | 43% |
| Nhc Advantage | $84 - $454 | 62% |
| Healthyblue | $89 - $478 | 66% |
| Coventry | $98 - $960 | 72% |
| United | $112 - $1,075 | 83% |
| Aetna | $116 - $1,219 | 86% |
| Universal Healthcare | $156 - $836 | 115% |
| Humana | $164 - $203 | 121% |
| Coventry Kc Mo | $182 - $980 | 134% |
| College Park Family Care Center | $191 - $1,027 | 141% |
| Oha Network | $222 - $1,195 | 164% |
| Multiplan | $236 - $1,911 | 174% |
| Corvel Corporation | $289 - $1,553 | 213% |
| Cco, Inc. | $333 - $1,792 | 246% |
| Triwest Health Alliance | $333 - $1,792 | 246% |
| Focus Healthcare Mgmt, Inc | $333 - $1,792 | 246% |
| Cigna | $356 - $1,911 | 263% |
Consumer Guidance & Cost Commentary
For CPT code 99214, representing an office visit for an established patient lasting 30 to 39 minutes, Menorah Medical Center in Overland Park, KS, lists a cash price of $1,711.00. This cash rate is significantly higher than the facility's negotiated rates, which range from $58 to $1,911 depending on the insurance carrier, with a median negotiated amount of $550.00. While commercial insurance contracts often cap charges at these negotiated levels, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds $1,711.00. It is important to note that the facility's cash price is also notably higher than the Medicare benchmark of $135.60, indicating a substantial markup relative to the federal government's cost-based reimbursement standard.
Patients should be aware that commercial insurance rates can sometimes exceed cash prices due to administrative costs and contract dynamics, making self-pay a viable option for those without immediate insurance coverage. Before scheduling, individuals should explicitly request "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, if you are using insurance, be cautious of balance billing scenarios where out-of-network providers bill the difference between the chargemaster and the insurance allowed amount, though the No Surprises Act protects many non-emergency services at in-network facilities. To ensure accuracy, always demand a full itemized bill before paying, as summary invoices may obscure unbundled charges or services not rendered, and dispute any errors in writing to protect your financial