CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ochsner Medical Center - Baton Rouge

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $94
Cash Discount Price: $44
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ochsner Medical Center - Baton Rouge is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.69x the Medicare baseline. Located in 17000 Medical Center Dr, Baton Rouge, LA.

Cash / Self-Pay

$44

Average discount available for prompt cash payment at this facility.

Insurance Median

$94

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: $44 (32%)

Insurance Median: $94 (69%)

Cash: $44 (32% of Medicare)

Ins. Median: $94 (69% 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
Zelis	$25	18%
UnitedHealthcare	$49 - $63	36%
Humana	$57	42%
Aetna	$58 - $111	43%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$58	43%
Healthy Blue (Healthy Louisiana)	$58	43%
Louisiana Healthcare Connections (Healthy Louisiana)	$58	43%
Medicaid / KanCare	$81	60%
Claritev D/B/A Multiplan/Phcs/American Life Care	$83	61%
Healthcomp & Personify Health (Formerly Gilsbar)	$83	61%
Louisiana Workers' Compensation Corporation (Lwcc)	$104	77%
Mississippi Physicians Care Network	$104	77%
First Health Network	$111	82%
Prime Health Services Ppo	$118	87%
Usa Managed Care Network	$118	87%
Blue Cross Blue Shield	$282 - $357	208%

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 $44.
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 Ochsner Medical Center - Baton Rouge 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.