CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ochsner Medical Center-Kenner

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $111
Cash Discount Price: $146
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ochsner Medical Center-Kenner is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.82x the Medicare baseline. Located in 180 West Esplanade Avenue, Kenner, LA.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $146 (108%)

Insurance Median: $111 (82%)

Cash: $146 (108% of Medicare)

Ins. Median: $111 (82% 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
Humana	$57	42%
UnitedHealthcare	$57 - $262	42%
Aetna	$58 - $465	43%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$58	43%
Healthy Blue (Healthy Louisiana)	$58	43%
Louisiana Healthcare Connections (Healthy Louisiana)	$58	43%
Zelis	$72 - $288	53%
Healthcomp & Personify Health (Formerly Gilsbar)	$78 - $314	58%
Medicaid / KanCare	$81 - $85	60%
Claritev D/B/A Multiplan/Phcs/American Life Care	$84 - $338	62%
First Health Network	$98 - $392	72%
Louisiana Workers' Compensation Corporation (Lwcc)	$98 - $392	72%
Mississippi Physicians Care Network	$98 - $392	72%
Galaxy Health Network Ppo	$104 - $418	77%
Galaxy Health Network Wc	$104 - $418	77%
Employers Health Network (Ehn)	$110 - $445	81%
Prime Health Services Ppo	$110 - $445	81%
Usa Managed Care Network	$110 - $445	81%
Blue Cross Blue Shield	$266 - $327	196%

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 $146.
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-Kenner 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.