CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $162
  • Cash Discount Price: $215
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Essentia Health St Joseph's Medical Center is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.19x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$215

Average discount available for prompt cash payment at this facility.

Insurance Median
$162

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: $215 (159%)
Insurance Median: $162 (119%)
Cash: $215 (159% of Medicare)
Ins. Median: $162 (119% 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
Medica Access $51 - $151 38%
Healthpartners Care Pmap $69 - $206 51%
Sanford Health Plan $69 - $216 51%
Blue Cross Blue Shield $72 - $335 53%
Blue Plus Pmap Pcc Prime $72 - $302 53%
Medica $102 - $338 75%
Medica Uplan $102 - $304 75%
Ucare $106 - $315 78%
Wea $116 - $368 86%
Medica Choice $117 - $348 86%
Cigna $118 - $351 87%
Healthpartners $118 - $351 87%
Healthpartners Pcc Prime $118 - $351 87%
UnitedHealthcare $123 - $364 91%
America'S Ppo $125 - $370 92%
Wps $134 - $402 99%
Aetna $137 - $406 101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals