Office visit, established patient (30-39 min)
Facility: Cottonwood Springs Llc
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $97
- Cash Discount Price: $800
- vs. Medicare Baseline: 0.72x 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 |
|---|---|---|
| First Health | $80 | 59% |
| Multiplan/Phcs/Beech Street | $85 | 63% |
| Compsych | $94 | 69% |
| Healthsmart | $100 | 74% |
| Velocity National Provider Network | $106 | 78% |
| Provider Networks Of America | $106 | 78% |
Consumer Guidance & Cost Commentary
For this office visit in Olathe, KS, the facility's cash price of $800.00 is significantly higher than the state average, which is approximately $135.60 based on Medicare benchmarks. While commercial insurance plans like First Health and Multiplan/Phcs/Beech Street negotiate rates as low as $80.00, these figures often represent the maximum allowed amount rather than the final patient cost. Patients with high-deductible plans should be aware that paying the cash price upfront might be more economical than relying on insurance, especially if the negotiated rate exceeds the cash price after deductibles are met. It is crucial to verify your specific deductible status before scheduling, as paying the full negotiated rate without meeting your plan's threshold can result in substantial out-of-pocket expenses.
To ensure you are not overcharged, always request a detailed itemized bill before finalizing payment, as summary invoices can obscure individual charges or unbundled services. If you receive a balance bill for the difference between the provider's full charge and your insurance allowed amount, you may be entitled to protections under the No Surprises Act, particularly if the care was provided at an in-network facility. Additionally, inquire about prompt-pay discounts, which can reduce the total cost by 20% to 50% if settled within 30 days, effectively bypassing the administrative costs associated with insurance claims processing. Always confirm that any discounts apply to your specific situation and that you have waived automatic insurance submission to secure the best possible rate.