CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Charlevoix Area Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

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

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Charlevoix Area Hospital is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.52x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$71

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: $71 (52%)

Insurance Median: $71 (52%)

Cash: $71 (52% 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
Blue Care Network	$20 - $84	15%
Hap (Health Alliance Plan)	$20 - $196	15%
Mclaren Health Plan	$20 - $127	15%
Medicare (plans)	$20 - $84	15%
Michigan Amish Medical Board	$20 - $84	15%
Northern Michigan Mennonite Group	$20 - $84	15%
UnitedHealthcare	$20 - $118	15%
Aetna	$21 - $123	15%
Priority Health	$21 - $136	15%
Molina	$22 - $84	16%
Hospice Of Michigan	$26 - $82	19%
Asr Physicians Care Network	$34 - $126	25%
Employee Benefits Logistics	$34 - $142	25%
Enterprise Group Planning Employee Benefit Plan	$34 - $109	25%
First Health/Coventry Health/Community Care Network	$34 - $109	25%
Medical Cost Savings Solution	$34 - $109	25%
Provider Network Of America/Hma Group Health	$37 - $183	27%
Three Rivers Provider Network	$37 - $116	27%
Blue Cross Blue Shield	$40 - $126	29%
Cofinity	$40 - $126	29%
Iba Health And Life Assurance Company	$40 - $125	29%
Nomi Health	$40 - $134	29%
Preferred Medical Claim Solutions	$41 - $129	30%
Cigna	$43 - $136	32%
Meridian	$62 - $92	46%

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 $71.
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 Charlevoix Area 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.