CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ortonville Area Health Services

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $26
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 0.19x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ortonville Area Health Services is $26. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.19x the Medicare baseline. Located in 450 Eastvold Ave, Ortonville, MN.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $30 (22%)
Insurance Median: $26 (19%)
Cash: $30 (22% of Medicare)
Ins. Median: $26 (19% 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 $17 13%
Medica Minnesota Senior Health Options (Msho)/Select Solution/Prime Solution $17 13%
Primewest $17 13%
Ucare Health $17 13%
UnitedHealthcare $17 - $31 13%
Health Partners $18 - $31 13%
Medica Choicecare/Accessibility Solution/Minnesotacare $21 15%
Sanford Health Plan $32 24%
Multiplan $33 24%
America'S Health System $34 25%
Blue Cross Blue Shield $34 25%
Medica Choice/Focus/Ifb/Mhps/Care System $34 25%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Eastvold Ave, Ortonville, MN 56278
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals