Office visit, established patient (30-39 min)
Facility: Republic County Hospital
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $141
- Cash Discount Price: $120
- vs. Medicare Baseline: 1.04x 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 |
|---|---|---|
| Rural Carriers-All Plans | $81 - $233 | 60% |
| Aetna | $86 - $247 | 63% |
| Meritain-All Plans | $86 - $247 | 63% |
| UnitedHealthcare | $87 - $252 | 64% |
| First Health-All Plans | $90 - $260 | 66% |
| Cigna | $90 - $260 | 66% |
| Midlands Choice-All Plans | $90 - $260 | 66% |
Consumer Guidance & Cost Commentary
For this office visit with an established patient lasting 30 to 39 minutes, the facility's cash price is $120.00, which is lower than the gross charge of $160.00. While the median negotiated rate across seven payers is $141.00, patients with high-deductible plans may find paying the cash price of $120.00 more cost-effective if their insurance allowed amount exceeds this figure. It is important to note that the cash price is significantly lower than the Medicare benchmark of $135.60, suggesting that the facility's self-pay rate is already competitive relative to the federal baseline. Additionally, the facility offers a prompt-pay discount, which can further reduce the final amount owed if settled in full within a short window.
The facility is located in Belleville, KS, and is rated 3 stars. While specific county or state average data was not provided in this report, the cash price of $120.00 serves as a solid baseline for comparison against any local averages you may have. If you choose to use insurance, be aware that the negotiated rates range from $81 to $260 depending on the carrier, with Rural Carriers-All Plans having the lowest range at $81 to $233. To ensure you are receiving the best possible rate, we recommend requesting an itemized bill before payment to verify that no unbundled codes or services not rendered are included, and asking explicitly about any self-pay or prompt-pay discounts available at registration.