Office visit, established patient (30-39 min)
Facility: Great Plains Of Sabetha
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $154
- Cash Discount Price: $183
- vs. Medicare Baseline: 1.14x 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 | $36 - $192 | 27% |
| Celtic Mcr Adv | $52 - $330 | 38% |
| Aetna | $53 - $334 | 39% |
| Celtic Comm Exchange-All Other Plans | $65 - $413 | 48% |
| Medicaid / KanCare | $72 - $256 | 53% |
| UnitedHealthcare | $72 - $256 | 53% |
| Great West Healthcare-All Plans | $85 - $218 | 63% |
| Cigna | $95 - $243 | 70% |
| Humana | $95 - $243 | 70% |
| Century/Wppa/Providers-All Plans | $95 - $243 | 70% |
| Multiplan-Phcs-All Plans | $95 - $243 | 70% |
| Federated Mutual Ins-All Plans | $96 - $246 | 71% |
Consumer Guidance & Cost Commentary
For CPT code 99214, an office visit for an established patient lasting 30 to 39 minutes, the facility in Sabetha, Kansas, lists a cash price of $183.00. This cash rate is identical to the facility's negotiated median paid amount of $154.00, which is notably lower than the gross charge of $183.00. While the data does not provide specific county or state average comparisons for this code, it is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. Patients with high-deductible plans may find paying the cash price directly more affordable than relying on insurance, as the insurer's allowed amount could potentially exceed the cash rate, leading to balance billing if the patient is out-of-network.
To minimize unexpected costs, patients should verify their insurance status and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can significantly reduce the final bill. If a patient receives a bill from an out-of-network provider, they should be aware of the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities. Furthermore, if a summary bill is received, patients should request a full itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies that can be corrected through a formal written dispute.