CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mercy Hospital Lincoln

Billing Code: 99214 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$149

about 1.1× the $136 Medicare rate · typically $73–$356

modeled estimate · not a bill or quote

Medicare pays $136 Fair price $149 Cash price $176 Hospital's list price $272

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$29 - $191	21%
Blue Cross Blue Shieldmajor	$31 - $363	23%
Aetnamajor	$20 - $190	15%
Cignamajor	$33 - $241	24%
Humanamajor	$31 - $261	23%
Ambetter (Centene)	$60 - $133	44%
HealthLink	$106 - $258	78%
Medica	$55 - $122	41%
+ 38 smaller / regional plans	$31 - $246

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 6 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 176), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99214.

Insurance Before you use insurance

Call your insurance company to confirm Mercy Hospital Lincoln is in-network.
Ask your insurer whether prior approval is required for CPT code 99214.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mercy Hospital Lincoln

Compare: Office visit, established patient (30-39 min) at other MO hospitals

Insurance negotiated median for the same procedure, sorted lowest first.