CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mercy Hospital Southeast

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $102
  • Cash Discount Price: $237
  • vs. Medicare Baseline: 0.75x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercy Hospital Southeast is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.75x the Medicare baseline. Located in 1701 Lacey St, Cape Girardeau, MO.
Cash / Self-Pay
$237

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $237 (175%)
Insurance Median: $102 (75%)
Cash: $237 (175% of Medicare)
Ins. Median: $102 (75% 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
Medicaid / KanCare $19 - $147 14%
Aetna $38 - $626 28%
Blue Cross Blue Shield $59 - $465 44%
First Health Contracted [320128] $79 - $626 58%
Health Alliance Contracted [320164] $81 - $636 60%
Aither Health Contracted [320449] $84 - $665 62%
Edison Health Solutions Contracted [320502] $84 - $665 62%
Healthlink Contracted [320179] $84 - $763 62%
Mercy Benefit Admin Contracted [320251] $84 - $665 62%
Mercy Benefit Admin [20251] $84 - $665 62%
Yuzu Health Contracted [320521] $84 - $665 62%
Cigna $87 - $14,290 64%
Cross Timbers Hospice [20098] $88 65%
Dept Of Veteran Affairs Contracted [320106] $88 65%
Elara Caring Aspire Hospice Contracted [320433] $88 65%
Elara Caring Aspire Hospice [20433] $88 65%
Halo Hcr Inc Hospice Contracted [320432] $88 65%
Halo Hcr Inc Hospice [20432] $88 65%
Humana $88 - $831 65%
Kindful Hospice Contracted [320434] $88 65%
Kindful Hospice [20434] $88 65%
Medicare (plans) $88 - $94 65%
Mercy Hospice Okc [20252] $88 65%
Pace Of The Ozarks Contracted [320518] $88 65%
Tricare $88 65%
UnitedHealthcare $88 - $216 65%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $91 67%
Workers Comp [20426] $93 - $782 69%
Multiplan Contracted [320270] $99 - $782 73%
Private Health Care Systems Contracted [320320] $99 - $782 73%
Provider Partners Health Plans Contracted [320450] $101 74%
Ambetter / Centene $117 86%
Home State Health Plan Contracted [320187] $117 86%
Consociate Consolidated Health Contracted [320490] $123 - $198 91%
Centivo Contracted [320505] $148 109%
Auxiant Contracted [320462] $153 - $181 113%
Ebms Contracted [320493] $153 113%
Imagine 360 Contracted [320494] $153 113%
Preferred Health Plan Contracted [320522] $157 116%
Reflect Health Contracted [320492] $158 117%
Hope Trust Contracted [320488] $220 162%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Lacey St, Cape Girardeau, MO 63701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals