CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ochsner St Anne General Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $71
Cash Discount Price: $64
vs. Medicare Baseline: 0.52x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ochsner St Anne General Hospital is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.52x the Medicare baseline. Located in 4608 Highway 1, Raceland, LA.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $64 (47%)

Insurance Median: $71 (52%)

Cash: $64 (47% of Medicare)

Ins. Median: $71 (52% 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
Tricare	$41 - $45	30%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$45	33%
Blue Cross Blue Shield	$45 - $430	33%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$45	33%
Humana	$45 - $57	33%
Medicare (plans)	$45	33%
Ochsner Health Plan	$45	33%
UnitedHealthcare	$45 - $62	33%
Healthy Blue (Healthy Louisiana)	$58	43%
Louisiana Healthcare Connections (Healthy Louisiana)	$58	43%
Aetna	$59 - $134	44%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$59	44%
Medicaid / KanCare	$81	60%
Healthcomp & Personify Health (Formerly Gilsbar)	$110	81%
Louisiana Workers' Compensation Corporation (Lwcc)	$110	81%
Mississippi Physicians Care Network	$110	81%
Employers Health Network (Ehn)	$124	91%
First Health Network	$124	91%
Prime Health Services Ppo	$124	91%
Claritev D/B/A Multiplan/Phcs/American Life Care	$131	97%
Usa Managed Care Network	$131	97%
Zelis	$131	97%

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 $64.
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 St Anne General 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.