CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ochsner Rush Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $162
Cash Discount Price: $81
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ochsner Rush Hospital is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.19x the Medicare baseline. Located in 1314 19Th Ave, Meridian, MS.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$162

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: $81 (60%)

Insurance Median: $162 (119%)

Cash: $81 (60% of Medicare)

Ins. Median: $162 (119% 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.

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
Humana	$73 - $246	54%
Medicaid / KanCare	$80 - $173	59%
Cigna	$89 - $246	66%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$89 - $246	66%
Medicare (plans)	$89 - $283	66%
UnitedHealthcare	$89 - $246	66%
Blue Cross Blue Shield	$91 - $126	67%
Aetna	$93 - $169	69%
Shared Health Mississippi	$93 - $258	69%
Prime Health Services Ppo	$102 - $208	75%
Claritev D/B/A Multiplan/Phcs/American Life Care	$104 - $195	77%
Ambetter / Centene	$124 - $162	91%
Select Administrative Services Network	$130 - $312	96%
Prime Health Services Ppo -Workers Comp	$133	98%
Cor Vel	$134 - $136	99%
Zelis	$135	100%
Primewell Health Services Commercial Exchange Plan	$141 - $185	104%
Primewell Health Services – Commercial	$141 - $185	104%

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 $81.
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 Ochsner Rush Hospital 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.