Office visit, established patient (30-39 min)
Facility: Mitchell County Hospital Health Systems
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $114
- Cash Discount Price: $136
- vs. Medicare Baseline: 0.84x 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 | 28% |
| Triwest Well Mark All Plans | $39 - $195 | 29% |
| Aetna | $39 - $194 | 29% |
| First Health-All Plans | $39 - $194 | 29% |
| UnitedHealthcare | $44 - $218 | 32% |
| Pref Hlth Care Sytms Comm - All Plans | $108 | 80% |
| Multiplan Ppo - All Plans | $114 | 84% |
| Auxiant-All Plans | $114 - $116 | 84% |
| Phc Leased Ntwrk Access - All Plans | $114 | 84% |
| Cigna | $119 | 88% |
| Health Partners Ks-All Plans | $119 - $138 | 88% |
Consumer Guidance & Cost Commentary
For this office visit with an established patient lasting 30 to 39 minutes, the facility's cash median rate is $136.00, while the median negotiated rate across insurance plans is $114.00. This suggests that for patients with high-deductible plans, paying cash upfront could be more cost-effective than relying on insurance, as the negotiated rates exceed the cash price. It is important to note that while the facility is in-network for many payers, the actual amount your specific plan pays will depend on your individual deductible status and the specific contract terms between your insurer and the hospital.
The facility's pricing is benchmarked against Medicare, which sets a baseline of $135.60 for this service. The cash rate of $136.00 is nearly identical to the Medicare amount, indicating that the facility's pricing aligns closely with federal cost standards rather than commercial markups. Additionally, the facility is a Critical Access Hospital in Beloit, KS, and offers a prompt-pay discount for patients who settle their bill in full within a short window, which can further reduce the final amount owed.