CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: New Ulm Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $151
Cash Discount Price: $200
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at New Ulm Medical Center is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.11x the Medicare baseline. Located in 1324 Fifth North Street, New Ulm, MN.

Cash / Self-Pay

$200

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $200 (147%)

Insurance Median: $151 (111%)

Cash: $200 (147% of Medicare)

Ins. Median: $151 (111% 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
Ucare Pmap (A B C D E G N O S U R H)	$25 - $86	18%
Medica Health System	$40 - $349	29%
Medicaid / KanCare	$55 - $98	41%
Medica	$56 - $331	41%
Medicare (plans)	$56	41%
Blue Cross Blue Shield	$59 - $852	44%
South Country Health Alliance	$63 - $66	46%
Aetna	$77 - $234	57%
Medica Ubh (N)	$88	65%
Americas Ppo (Araz)(B D N O R S V)	$98	72%
Cigna	$103 - $324	76%
Americas Ppo (Araz) (B D N H O R S)	$106	78%
First Health (A C E G H U B D N O R S)	$106 - $359	78%
Hennepin Health	$112	83%
Health Partners	$118 - $297	87%
UnitedHealthcare	$123 - $271	91%
All Other Contracted Care (A B C D E G H N O R S U)	$126	93%
Medica Dual Solutions (A U)	$190	140%
Americas Ppo (Araz)(A M U)	$279 - $286	206%
Medica Ubh (A)	$292 - $299	215%
Medica Mhps	$332	245%
Bc Aware/Blue Plus (Nr)	$589	434%

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 $200.
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 New Ulm Medical Center 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.