Office visit, established patient (30-39 min)
Facility: Smith County Memorial Hospital
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $138
- Cash Discount Price: $170
- vs. Medicare Baseline: 1.02x 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 - $80 | 28% |
| Medicaid / KanCare | $88 - $275 | 65% |
| Multiplan-All Plans | $113 - $248 | 83% |
| Wppa-All Plans | $118 - $258 | 87% |
| Midlands Choice-All Plans | $120 - $261 | 88% |
| Health Partners Of Ks Ppo-All Plans | $120 - $261 | 88% |
| UnitedHealthcare | $120 - $261 | 88% |
Consumer Guidance & Cost Commentary
For CPT code 99214, representing an office visit for an established patient lasting 30 to 39 minutes, Smith County Memorial Hospital in Smith Center, KS, lists a cash price of $170.00. This cash rate is identical to the facility's median paid amount of $156.00 and matches the Medicare benchmark of $135.60 exactly. While the facility is a Critical Access Hospital owned by the local government, the data does not provide specific county or state average figures for this procedure, so a direct comparison to regional pricing is not possible based on the available information.
Patients should be aware that while insurance plans like Blue Cross Blue Shield, Medicaid/KanCare, and UnitedHealthcare have negotiated rates ranging from $38 to $275, these amounts often exceed the cash price due to administrative costs and contract structures. If you have a high-deductible plan, paying the $170.00 cash rate upfront may be more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if your deductible has not been met. To ensure you receive the best possible rate, we strongly recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.