CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ochsner University Hospital and Clinics

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $75
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 0.55x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ochsner University Hospital and Clinics is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.55x the Medicare baseline. Located in 2390 West Congress, Lafayette, LA.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $39 (29%)
Insurance Median: $75 (55%)
Cash: $39 (29% of Medicare)
Ins. Median: $75 (55% 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
Blue Cross Blue Shield $41 - $372 30%
Verity Commercial And First Choice Network $48 - $52 35%
Aetna $57 - $97 42%
Amerihealth Caritas Louisiana (Healthy Louisiana) $57 - $63 42%
Healthy Blue (Healthy Louisiana) $57 - $63 42%
Humana $57 - $63 42%
Louisiana Healthcare Connections (Healthy Louisiana) $57 - $63 42%
UnitedHealthcare $57 - $95 42%
Healthy Blue Dual Advantage (Hmo-D-Snp) $91 67%
Medicare (plans) $91 67%
Ochsner Health Plan $91 67%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan) $93 69%
Tricare $93 69%
Cigna $99 73%
Zelis $113 83%
Wellcare Of Louisiana $118 87%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2390 West Congress, Lafayette, LA 70506
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals