Office visit, established patient (30-39 min)
Facility: Minneola District Hospital
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $242
- Cash Discount Price: $179
- vs. Medicare Baseline: 1.78x 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 | $38 - $189 | 28% |
| Corporate Plan Management-All Plans | $144 - $382 | 106% |
| Providrs Care Network-All Plans | $144 - $382 | 106% |
| Triwest-All Plans | $153 - $405 | 113% |
| Preferred Health Care (Coventry)-All Other Plans | $153 - $405 | 113% |
| Health Partners Of Kansas-All Plans | $162 - $428 | 119% |
| Aetna | $162 - $450 | 119% |
| UnitedHealthcare | $162 - $450 | 119% |
| Phc (Coventry) Leased Network | $162 - $428 | 119% |
| Medicaid / KanCare | $170 - $450 | 125% |
| Humana | $171 - $391 | 126% |
| Va Community Care Program-All Plans | $171 - $391 | 126% |
Consumer Guidance & Cost Commentary
For CPT code 99214, representing an office visit with an established patient (30-39 minutes), the facility in Minneola, KS, lists a cash median of $179.00 and a median negotiated rate of $242.00. This cash price is notably lower than the facility's gross charge of $255.00 and aligns closely with the state average, as the data indicates a 1.8x multiplier relative to the Medicare amount of $135.60. While commercial payers negotiate rates ranging from $38 to $450 depending on the plan, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $179.00, as paying upfront can bypass administrative fees and potential balance billing.
To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can range from 20% to 50% and provide immediate liquidity benefits by avoiding costly claims processing. It is crucial to avoid accepting summary bills without reviewing the full itemized statement, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should verify their deductible status and ensure they are not signing away rights to dispute out-of-network ancillary charges before finalizing any payment plan.