Office visit, established patient (30-39 min)
Facility: Neosho Memorial Regional Medical Center
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $90
- Cash Discount Price: $112
- vs. Medicare Baseline: 0.66x 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 |
|---|---|---|
| Tricare | $33 - $86 | 24% |
| Medadv_Allwell | $35 - $142 | 26% |
| Blue Cross Blue Shield | $35 - $208 | 26% |
| Medicare (plans) | $35 - $142 | 26% |
| Humana | $35 - $142 | 26% |
| Va_Ccn | $35 - $142 | 26% |
| Aetna | $35 - $108 | 26% |
| Medadv_Uhc | $35 - $142 | 26% |
| Ambetter / Centene | $55 - $140 | 41% |
| United | $90 - $232 | 66% |
| Wppa_Providrscare | $90 - $231 | 66% |
| Coventry | $103 - $265 | 76% |
| Cigna | $103 - $265 | 76% |
| Hpk | $103 - $265 | 76% |
Consumer Guidance & Cost Commentary
For this office visit with an established patient at Neosho Memorial Regional Medical Center in Chanute, KS, the facility's cash price is $112.00, which is lower than the gross charge of $150.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, the median negotiated rate across payers is $90.00, yet many commercial plans have allowed amounts ranging from $103 to $265, meaning patients with high-deductible plans might pay less out-of-pocket by paying the cash price directly. It is advisable to contact the hospital before scheduling to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final bill if payment is made upfront.
When using insurance, patients should be cautious of balance billing, where the provider bills the difference between the full charge and the insurance allowed amount, though the No Surprises Act protects against this for emergency care and non-emergency services at in-network facilities. If a patient receives a surprise bill, they should dispute it in writing with the insurer rather than paying immediately to avoid unnecessary debt. Additionally, since over 80% of hospital bills contain errors, patients should request a detailed itemized audit to identify unbundled codes or services not rendered before agreeing to any payment plan. The facility's Medicare benchmark of $135.60 serves as a reliable baseline for evaluating pricing; commercial rates are often significantly higher than this federal standard, and comparing the facility's specific negotiated rates to Medicare helps clarify the true cost of care rather than relying on