Office visit, established patient (30-39 min)
Facility: Amberwell Atchison Association
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $170
- Cash Discount Price: $298
- vs. Medicare Baseline: 1.25x 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 |
|---|---|---|
| Triwest - All Plans | $66 - $148 | 49% |
| Humana | $66 - $1,551 | 49% |
| Va Ccn - All Plans | $66 - $148 | 49% |
| UnitedHealthcare | $66 - $804 | 49% |
| Superior Select Mcr Adv - All Plans | $66 - $224 | 49% |
| Ambetter / Centene | $102 - $229 | 75% |
| Cigna | $109 - $246 | 80% |
| Aetna | $109 - $246 | 80% |
| Centrus Health Direct - All Plans | $149 - $336 | 110% |
| Oscar - All Plans | $149 - $336 | 110% |
| Multiplan - All Plans | $155 - $349 | 114% |
| Blue Cross Blue Shield | $179 - $189 | 132% |
| Wppa Providrs Care - All Plans | $179 - $403 | 132% |
Consumer Guidance & Cost Commentary
For this office visit with an established patient (30-39 minutes) at Amberwell Atchison Association, the cash price is $298.00, which matches the facility's median paid amount. While the facility is a Critical Access Hospital in Atchison, KS, the data provided does not include specific county or state average figures for comparison. It is important to note that commercial insurance negotiated rates vary significantly by payer, ranging from a low of $66 to a high of $1,551 across different plans. For patients with high-deductible plans, paying the cash price of $298.00 upfront may be more cost-effective than relying on insurance, as many commercial negotiated rates exceed the cash price due to administrative overhead and contract structures.
Before scheduling, patients should verify their specific plan's negotiated rate and check for "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full within 30 days. Although the Medicare benchmark for this service is $135.60, commercial rates often average 200% to 300% of this amount, so comparing the cash price directly to the Medicare rate provides a clearer picture of fair pricing than looking at the hospital's gross charges. If you receive a bill after using insurance, request an itemized statement to review every code and ensure no services were billed that were not rendered, as over 80% of hospital bills contain errors that can be corrected. Always confirm your deductible status before proceeding, as you may be responsible for the full negotiated rate if you have not yet met your plan's out-of-pocket maximum.