CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Rockcastle County Hospital, Inc.

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $119
  • Cash Discount Price: $126
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Rockcastle County Hospital, Inc. is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.88x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$126

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $126 (93%)
Insurance Median: $119 (88%)
Cash: $126 (93% of Medicare)
Ins. Median: $119 (88% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Passport Hp Hmo - All Plans $25 - $207 18%
Tricare $62 46%
Blue Cross Blue Shield $63 - $268 46%
Caresource Mcaid $67 - $207 49%
Coventry Mcaid-All Plans $67 - $207 49%
Medicaid / KanCare $67 - $207 49%
Molina Mcaid $67 - $207 49%
UnitedHealthcare $67 - $207 49%
Multiplan-All Plans $71 - $304 52%
Prime Health Services-All Plans $75 - $304 55%
Caresource Mcr Adv-All Other Plans $82 60%
Humana $82 60%
Integrated Hp-All Plans $82 - $319 60%
Molina Marketplace - All Other Plans $82 60%
Molina Mcr Adv $82 60%
Signature Mcr Adv-All Plans $82 60%
Wellcare Mcr Adv-All Other Plans $82 60%
Corvel - All Plans $83 - $322 61%
Center Care-All Plans $87 - $340 64%
Cigna $89 - $347 66%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals