CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Abrom Kaplan Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $93
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 0.69x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Abrom Kaplan Memorial Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.69x the Medicare baseline. Located in 1310 West Seventh Street, Kaplan, LA.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $68 (50%)
Insurance Median: $93 (69%)
Cash: $68 (50% of Medicare)
Ins. Median: $93 (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.

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 - $315 30%
Verity Commercial And First Choice Network $53 - $68 39%
Aetna $57 - $395 42%
Amerihealth Caritas Louisiana (Healthy Louisiana) $57 - $395 42%
Healthy Blue (Healthy Louisiana) $57 - $395 42%
Humana $57 - $395 42%
Louisiana Healthcare Connections (Healthy Louisiana) $57 - $395 42%
UnitedHealthcare $57 - $395 42%
Healthy Blue Dual Advantage (Hmo-D-Snp) $68 - $139 50%
Medicare (plans) $68 - $139 50%
Ochsner Health Plan $68 - $139 50%
Wellcare Of Louisiana $68 - $139 50%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan) $70 - $143 52%
Tricare $79 - $121 58%
Cigna $99 - $126 73%
Zelis $106 - $136 78%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1310 West Seventh Street, Kaplan, LA 70548
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals