CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Womans Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $194
Cash Discount Price: $243
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Womans Hospital is $194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $243. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.43x the Medicare baseline. Located in 100 Woman's Way, Baton Rouge, LA.

Cash / Self-Pay

$243

Average discount available for prompt cash payment at this facility.

Insurance Median

$194

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: $243 (179%)

Insurance Median: $194 (143%)

Cash: $243 (179% of Medicare)

Ins. Median: $194 (143% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Webtpa [100127]	$146 - $191	108%
Fmolhs Employees [100257]	$170	125%
UnitedHealthcare	$180 - $194	133%
Blue Cross Blue Shield	$191	141%
La Women'S Healthcare [100265]	$191	141%
Verity [100266]	$191	141%
Aetna	$194 - $228	143%
Cigna	$194 - $202	143%
Coventry [100010]	$194	143%
Ppo Plus [100259]	$194	143%
Beech Street [100260]	$207	153%
Multiplan [100258]	$214	158%
Private Health [100261]	$214	158%
Humana	$228	168%
Meritain [100063]	$228	168%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $243.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Womans Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.