CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Merit Health Madison

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$110
about 0.8× the $136 Medicare rate · typically $86–$201
modeled estimate · not a bill or quote
What this hospital charges insurers
$126
About the fair price
about $16 over the fair price · 0.9× Medicare
Medicare pays $136 Fair price $110 This hospital $126 Cash price $132 Hospital's list price $331

How we calculate the fair BaseRate →

How this hospital compares to other MS hospitals

Highest price of the 9 MS hospitals we have prices for — worth calling around.

Cheapest $59 Priciest $126

Black dot = this hospital, among the 9 MS hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (30-39 min) is about $110 (about 0.8× the $136 Medicare rate). Merit Health Madison charges insurers about $126, or about $132 in cash — about the fair price. Located in Canton, MS.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Cigna✓ Humana AetnaKaiser 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 $73 - $75 54%
Blue Cross Blue Shieldmajor $91 67%
Cignamajor $232 171%
Humanamajor $125 92%
Ambetter (Centene) $182 134%
Devoted Health $126 93%
Molina $82 - $258 60%
WellCare $124 91%
+ 6 smaller / regional plans $83 - $244
Government programs also on file: Medicare.

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Facility Profile & Credentials

  • Address: 161 River Oaks Drive, Canton, MS 39046
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals