CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Medstar Harbor Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $148
  • Cash Discount Price: $145
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Medstar Harbor Hospital is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.09x the Medicare baseline. Located in 3001 South Hanover Street, Baltimore, MD.
Cash / Self-Pay
$145

Average discount available for prompt cash payment at this facility.

Insurance Median
$148

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: $145 (107%)
Insurance Median: $148 (109%)
Cash: $145 (107% of Medicare)
Ins. Median: $148 (109% 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
Aetna $148 109%
Amerigroup $148 109%
Amerihealth Caritas District Of Columbia $148 109%
Carefirst Advantage Inc $148 109%
Carefirst Blue Choice Inc $148 109%
Cigna $148 109%
First Health $148 109%
Hscsn $148 109%
Humana $148 109%
Kaiser Permanente $148 109%
Magellan Behavioral Health Inc $148 109%
Mamsi $148 109%
Medstar Family Choice $148 109%
Medstar Family Choice Inc $148 109%
Ncppo Healthlink Ppo $148 109%
Pfc $148 109%
Private Healthcare Systems (Phcs) $148 109%
Tricare $148 109%
United Behavioral Health Inc $148 109%
UnitedHealthcare $148 109%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3001 South Hanover Street, Baltimore, MD 21225
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals