Office visit, established patient (30-39 min)
Facility: Rawlins County Health Center
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $239
- Cash Discount Price: $234
- vs. Medicare Baseline: 1.76x 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 |
|---|---|---|
| Blue Cross Blue Shield | $189 | 139% |
| UnitedHealthcare | $209 - $326 | 154% |
Consumer Guidance & Cost Commentary
For this office visit at Rawlins County Health Center in Atwood, Kansas, the cash price of $234 is significantly lower than the facility's negotiated rates with UnitedHealthcare, which range from $209 to $326 depending on the specific plan. While Blue Cross Blue Shield has a single plan at $189, patients with high-deductible plans might find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that the cash price is also lower than the state average for this service, making it a competitive option for self-pay patients.
The Medicare benchmark for this procedure is $135.60, which serves as a baseline for evaluating the facility's pricing. The cash price of $234 represents a markup of 1.8 times the Medicare rate, which aligns with typical commercial pricing structures where negotiated rates often exceed fair value benchmarks. To ensure you are receiving the best possible rate, we recommend asking the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final amount owed.