Office visit, established patient (30-39 min)
Facility: Lincoln County Hospital
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $189
- Cash Discount Price: $115
- vs. Medicare Baseline: 1.39x 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% |
Consumer Guidance & Cost Commentary
For this office visit with an established patient at Lincoln County Hospital in Lincoln, KS, the cash price is $115.00, which is lower than the facility's negotiated rate of $189.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance negotiated rate exceeds this cash price. It is important to note that the cash price is also lower than the Medicare benchmark of $135.60, suggesting that the facility is pricing below the federal cost baseline for this service.
The data indicates a single payer, Blue Cross Blue Shield, with a negotiated rate of $189.00, which is significantly higher than the cash option. Although specific county or state average comparisons are not provided in the current dataset, the disparity between the cash rate and the negotiated rate highlights the potential savings available for self-pay patients. To maximize these savings, consumers should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals often offer fee reductions for upfront payments that bypass the administrative costs associated with insurance billing. Always verify the exact allowed amount with the hospital prior to receiving care to ensure you are aware of the final financial obligation.