CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Lafayette Regional Health Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $227
  • Cash Discount Price: $713
  • vs. Medicare Baseline: 1.67x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Lafayette Regional Health Center is $227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $713. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.67x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$713

Average discount available for prompt cash payment at this facility.

Insurance Median
$227

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: $713 (526%)
Insurance Median: $227 (167%)
Cash: $713 (526% of Medicare)
Ins. Median: $227 (167% 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
Nhc Advantage $44 - $227 32%
Healthyblue $46 - $239 34%
United $58 - $539 43%
Aetna $60 - $1,047 44%
Universal Healthcare $60 - $311 44%
Humana $78 - $515 58%
College Park Family Care Center $99 - $515 73%
Oha Network $115 - $598 85%
Cigna $131 - $855 97%
Multiplan $179 - $934 132%
Coventry $183 - $955 135%
Coventry Kc Mo $183 - $955 135%
Cco, Inc. $195 - $1,017 144%
Corvel Corporation $195 - $1,017 144%
Focus Healthcare Mgmt, Inc $206 - $1,077 152%
Blue Cross Blue Shield $229 - $1,197 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals