CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Holmes County Hospital and Clinics

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $183
  • Cash Discount Price: $98
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Holmes County Hospital and Clinics is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.35x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.
Cash / Self-Pay
$98

Average discount available for prompt cash payment at this facility.

Insurance Median
$183

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: $98 (72%)
Insurance Median: $183 (135%)
Cash: $98 (72% of Medicare)
Ins. Median: $183 (135% 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
Ms-Can-Molina-Lex $82 60%
Ms-Can-Magnolia-Lex $83 61%
Ms-Can-Truecare-Lex $84 62%
Blue Cross Blue Shield $128 94%
Cigna $142 105%
Tricare $150 111%
Humana $152 112%
Mpcn-Lex $159 117%
Medadv_Uhc-Lex $166 122%
Firstchoice-Lex $171 126%
Molina-Chip-Lex $176 130%
Magnolia-Chip-Lex $180 133%
Truecare-Chip-Lex $180 133%
United-Lex $182 134%
Ambetter / Centene $183 135%
Medadv_Primewell-Lex $183 135%
Medicare (plans) $183 135%
Primewell-Lex $183 135%
United-Options-Lex $183 135%
Va_Ccn-Lex $183 135%
Medadv_Uhcdsnp-Lex $188 139%
Wellcare-Lex $188 139%
Ppoplus $190 140%
Devoted_Health-Lex $192 142%
Firsthealth-Lex $195 144%
Multiplan-Lex $195 144%
Aetna $207 153%
Phcs-Lex $220 162%
Advhealth-Lex $244 180%
Molina_Exchange-Lex $244 180%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 239 Bowling Green Road, Lexington, MS 39095
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals