CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Essentia Health Northern Pines Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $113
  • Cash Discount Price: $131
  • vs. Medicare Baseline: 0.83x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Essentia Health Northern Pines Medical Center is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $131. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.83x the Medicare baseline. Located in 5211 Highway 110, Aurora, MN.
Cash / Self-Pay
$131

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $131 (97%)
Insurance Median: $113 (83%)
Cash: $131 (97% of Medicare)
Ins. Median: $113 (83% 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
Blue Cross Blue Shield $58 - $164 43%
Blue Plus Pmap Pcc Prime $58 - $112 43%
Advocare/Security Health $59 - $80 44%
Freedom Blue Ppo $59 - $80 44%
Healthpartners Care Msho / Mcr Adv $59 - $80 44%
Imcare Msho Pcc Prime $59 - $80 44%
Imcare Msho Ref Req $59 - $80 44%
Medica Advantage Solutions $59 - $80 44%
Medica Msho/Dual Solutions $59 - $80 44%
Medica Prime Solution Group $59 - $80 44%
Medicare (plans) $59 - $80 44%
Nd Va Administration $59 - $80 44%
Platinum Blue/Vantage Blue $59 - $80 44%
Primewest Msho $59 - $80 44%
Secure Blue Msho $59 - $80 44%
Ubh Cost Plan $59 - $80 44%
Ubh Msho $59 - $80 44%
Ucare Msho $59 - $80 44%
UnitedHealthcare $59 - $185 44%
Medica Access $60 - $127 44%
Healthpartners Care Pmap $61 - $82 45%
Sanford Healthplan $65 - $92 48%
Ucare $99 - $134 73%
Healthpartners $102 - $163 75%
Medica $108 - $162 80%
Medica Uplan $108 - $146 80%
Wea $109 - $157 80%
America'S Ppo $117 - $158 86%
Cigna $118 - $163 87%
Healthpartners Pcc Prime $118 - $163 87%
Medica Choice $124 - $167 91%
Wps $125 - $171 92%
Aetna $128 - $173 94%
Healtheos $130 - $175 96%
Security Health $151 - $204 111%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5211 Highway 110, Aurora, MN 55705
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals