Office visit, established patient (30-39 min)
Facility: Wichita County Health Center
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $115
- Cash Discount Price: $92
- vs. Medicare Baseline: 0.85x 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 |
|---|---|---|
| Medicaid / KanCare | $86 - $339 | 63% |
| UnitedHealthcare | $104 - $125 | 77% |
Consumer Guidance & Cost Commentary
For this office visit at Wichita County Health Center in Leoti, KS, the cash price of $92.00 is notably lower than the facility's median negotiated rate of $115.00, which aligns with the median negotiated amount reported for this service. While the facility is a Critical Access Hospital owned by the local government, the cash price remains a significant factor for patients with high-deductible plans or those seeking to minimize out-of-pocket costs. It is important to note that for some commercial payers, the negotiated rate can exceed the cash price; for instance, UnitedHealthcare plans may face a negotiated rate between $104 and $125, whereas Medicaid/KanCare plans range from $86 to $339. Patients should verify their specific plan's allowed amount before scheduling, as the cash rate of $92.00 could result in lower total costs if the insurance negotiated rate is higher than the cash price.
To ensure you are paying the most accurate amount possible, always request an itemized bill that lists specific CPT codes rather than accepting a summary invoice that obscures individual charges. This audit helps identify errors such as unbundled services or charges for items never rendered, which can significantly reduce medical debt. Additionally, if you choose to pay out-of-pocket, ask the billing department about prompt-pay discounts, which can reduce the total amount due by 20% to 50% if settled within 30 days. While the Medicare benchmark for this code is $135.60, commercial rates vary widely by payer, so comparing your specific allowed amount against the cash price is the most effective way to determine the best financial outcome for your