CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Tj Health Columbia

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $107
  • Cash Discount Price: $178
  • vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Tj Health Columbia is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.79x the Medicare baseline. Located in 901 Westlake Drive, Columbia, KY.
Cash / Self-Pay
$178

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $178 (131%)
Insurance Median: $107 (79%)
Cash: $178 (131% of Medicare)
Ins. Median: $107 (79% 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
Aetna $67 - $307 49%
Blue Cross Blue Shield $67 - $307 49%
Humana $67 - $307 49%
Molina Mcaid $69 - $316 51%
Devoted Mcr Adv - All Plans $72 - $92 53%
Center Care Select - All Plans $82 - $169 60%
Signature Advantage - All Plans $83 61%
Molina Mcr Adv $84 62%
Caresource - All Plans $107 - $124 79%
Molina Marketplace - All Other Plans $107 - $124 79%
Phcs/Multiplan - All Plans $289 213%
First Health - All Plans $292 215%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Westlake Drive, Columbia, KY 42728
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals