CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Sanford Bemidji Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $234
  • Cash Discount Price: $230
  • vs. Medicare Baseline: 1.73x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Sanford Bemidji Medical Center is $234. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $230. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.73x the Medicare baseline. Located in 1300 Anne St Nw, Bemidji, MN.
Cash / Self-Pay
$230

Average discount available for prompt cash payment at this facility.

Insurance Median
$234

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: $230 (170%)
Insurance Median: $234 (173%)
Cash: $230 (170% of Medicare)
Ins. Median: $234 (173% 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
Sanford Health Plan Align $117 86%
Ucare $126 - $223 93%
Aetna $127 - $260 94%
Blue Cross Blue Shield $127 - $176 94%
Health Partners $127 - $222 94%
Medicare (plans) $127 94%
Sanford Health Plan $127 - $194 94%
UnitedHealthcare $127 - $265 94%
Primewest $129 95%
Security Health Plan $153 - $174 113%
Medica $234 - $285 173%
Cigna $250 - $285 184%
First Choice Health Network $250 - $285 184%
Healthez $250 - $285 184%
Multiplan $250 - $285 184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1300 Anne St Nw, Bemidji, MN 56601
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals