Office visit, established patient (30-39 min)
Facility: Stanton County Hospital
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $207
- Cash Discount Price: $138
- vs. Medicare Baseline: 1.53x 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 | $179 - $230 | 132% |
| Healthy Blue Mcaid | $207 | 153% |
| Healthy Blue Mcr Adv - All Other Plans | $238 | 176% |
Consumer Guidance & Cost Commentary
For CPT code 99214, representing an office visit with an established patient lasting 30 to 39 minutes, Stanton County Hospital in Johnson, KS, lists a cash price of $138.00. This cash rate is identical to the facility's median paid amount and matches the Medicare benchmark of $135.60, indicating a pricing structure that aligns closely with federal cost baselines. Notably, the facility's negotiated rates with major payers such as Blue Cross Blue Shield ($179–$230) and Healthy Blue ($207–$238) exceed the cash price, which can be advantageous for patients with high-deductible plans who may pay less out-of-pocket if their insurance covers the service. However, patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts, as these upfront fee reductions can further lower the total cost.
While the facility is a Critical Access Hospital owned by the local government, the data does not provide a specific county or state average for comparison against this service. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% compared to cash prices. If you are billed for this service, you should request an itemized bill to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. Furthermore, if you receive a balance bill from an out-of-network provider at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency and