CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Holland Community Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $118
  • Cash Discount Price: $104
  • vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Holland Community Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.87x the Medicare baseline. Located in 602 Michigan Ave, Holland, MI.
Cash / Self-Pay
$104

Average discount available for prompt cash payment at this facility.

Insurance Median
$118

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: $104 (77%)
Insurance Median: $118 (87%)
Cash: $104 (77% of Medicare)
Ins. Median: $118 (87% 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
Molina Mcaid - All Plans $38 - $94 28%
Ph Mcaid $38 - $94 28%
UnitedHealthcare $41 - $295 30%
Nomi Health - All Plans $65 - $162 48%
Life Circles-All Plans $80 59%
Meridian Mcaid Profee Only-All Plans $82 60%
Aetna $83 - $236 61%
Cofinity -All Plans $83 - $206 61%
Health Alliance Mcr Adv $84 62%
Ph Mcr Adv $84 62%
Va Ccn - All Plans $84 62%
Longevity Health Plan-All Plans $90 66%
Cigna $100 - $148 74%
Multiplan - All Plans $103 - $257 76%
Benefit Source Inc-All Plans $106 - $266 78%
First Health-All Plans $106 - $266 78%
Usa Managed Care-All Plans $106 - $266 78%
Priority Health - All Other Plans $110 - $164 81%
Integrated Health Plans-All Plans $112 - $280 83%
Blue Care Network - All Plans $116 86%
Blue Cross Blue Shield $124 - $231 91%
Sisco-All Other Plans $140 - $308 103%
Asr - All Plans $169 - $198 125%
Health Alliance Ahl - All Other Plans $169 - $198 125%
Health Alliance Hmo $169 - $190 125%
Sisco Epi $308 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 602 Michigan Ave, Holland, MI 49423
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals