CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Kiowa District Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $197
  • Cash Discount Price: $164
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Kiowa District Hospital is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.45x the Medicare baseline. Located in 1002 South 4Th Street, Kiowa, KS.
Cash / Self-Pay
$164

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $164 (121%)
Insurance Median: $197 (145%)
Cash: $164 (121% of Medicare)
Ins. Median: $197 (145% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $38 - $80 28%
UnitedHealthcare $72 - $275 53%
Medicaid / KanCare $72 - $261 53%
Humana $81 - $275 60%
Triwest-All Plans $81 - $275 60%
Tricare $81 - $275 60%
Healthchoice-All Plans $97 - $161 72%
Health Partners Of Ks-All Plans $176 - $185 130%
Gbs Insurance - All Plans $188 - $197 139%
Multiplan-All Plans $188 - $197 139%
Medicare (plans) $200 - $265 147%
Aetna $200 - $275 147%
Providers Care (Wppa)-All Plans $300 - $315 221%
Liberty Healthshare-All Plans $339 - $467 250%

Consumer Guidance & Cost Commentary

For CPT code 99214, representing an office visit with an established patient lasting 30 to 39 minutes, the facility in Kiowa, KS, has a cash median price of $164.00 and a median negotiated rate of $197.00. While the gross charge listed is $205.00, patients should note that cash payments can sometimes be more cost-effective than using insurance, particularly if your plan has a high deductible or if the insurance negotiated rate exceeds the cash price. It is important to verify your specific plan's allowed amount before scheduling, as some in-network rates can vary significantly between providers. Additionally, you may be eligible for a prompt-pay discount if you choose to settle the bill in full upfront, which can reduce the total amount owed.

This service is provided at Kiowa District Hospital, a Critical Access Hospital in the state of Kansas. The facility's pricing data reflects a specific vintage of 2026-06 and includes a comparison metric against Medicare, which serves as a baseline for fair pricing. While the report does not provide explicit county or state average figures for this specific code, the facility's ownership is designated as a Government Hospital District or Authority. Consumers are advised to request an itemized bill to ensure all charges are accurate and to avoid balance billing, which is largely prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. Always confirm your out-of-network status and request a waiver of insurance submission if you intend to pay cash directly to avoid unexpected billing complications.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1002 South 4Th Street, Kiowa, KS 67070
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals