CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Baptist Memorial Hospital Booneville

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $404
Cash Discount Price: $169
vs. Medicare Baseline: 2.98x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Baptist Memorial Hospital Booneville is $404. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 2.98x the Medicare baseline. Located in 100 Hospital Street, Booneville, MS.

Cash / Self-Pay

$169

Average discount available for prompt cash payment at this facility.

Insurance Median

$404

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: $169 (125%)

Insurance Median: $404 (298%)

Cash: $169 (125% of Medicare)

Ins. Median: $404 (298% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 298% of the Medicare baseline (a markup of 198%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$79 - $774	58%
Magnolia Ms	$88 - $280	65%
Advanced Health Systems Inc.	$122	90%
Blue Cross Blue Shield	$122	90%
Ppo Holdings	$148 - $470	109%
Magnolia Regional Health Center	$156 - $494	115%
Littler	$195 - $618	144%
Molina	$195 - $618	144%
Mpcn	$203 - $643	150%
Cigna	$214 - $680	158%
Primewell	$234 - $742	173%
UnitedHealthcare	$234 - $742	173%
Humana	$257 - $816	190%
First Choice Health Plan Of Ms	$273 - $865	201%
Multiplan	$292 - $927	215%
Novasys	$292 - $927	215%
Christian Health Aid	$312 - $989	230%
Ppo Plus	$332 - $1,051	245%
Qca	$351 - $1,112	259%

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 $169.
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 Baptist Memorial Hospital Booneville 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.