Office visit, established patient (30-39 min)
Facility: Osborne County Memorial Hospital
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $148
- Cash Discount Price: $136
- vs. Medicare Baseline: 1.09x 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 |
|---|---|---|
| UnitedHealthcare | $86 - $342 | 63% |
| Health Partners Of Kansas | $97 - $387 | 72% |
| Wppa | $107 - $428 | 79% |
| Blue Cross Blue Shield | $111 - $441 | 82% |
Consumer Guidance & Cost Commentary
For this established patient office visit at Osborne County Memorial Hospital, the cash price of $136 is lower than the facility's negotiated rates, which range from $97 to $441 depending on the insurance carrier. While the facility is a Critical Access Hospital in Osborne, Kansas, the data provided does not include specific county or state average benchmarks for comparison. However, it is important to note that commercial negotiated rates often exceed the cash price due to administrative costs and contract structures; therefore, patients with high-deductible plans may find paying the cash rate of $136 more cost-effective than relying on insurance, especially if their deductible has not yet been met.
The Medicare benchmark for this service is $135.60, which serves as a scientifically validated baseline for evaluating pricing markups. The facility's cash rate of $136 is nearly identical to the Medicare amount, whereas the median negotiated rate across payers is $148. Because the cash price is so close to the Medicare baseline, patients should verify their specific insurance allowed amounts before scheduling, as some in-network plans may result in higher out-of-pocket costs than paying cash directly. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts before check-in, as these upfront fee reductions can further lower the total cost by bypassing the administrative overhead associated with insurance billing cycles.