CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Novant Health Forsyth Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $243
  • Cash Discount Price: $211
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Novant Health Forsyth Medical Center is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.79x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.
Cash / Self-Pay
$211

Average discount available for prompt cash payment at this facility.

Insurance Median
$243

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: $211 (156%)
Insurance Median: $243 (179%)
Cash: $211 (156% of Medicare)
Ins. Median: $243 (179% 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
Carolina Complete $65 - $66 48%
Nc Department Of Public Safety $65 - $66 48%
Amerihealth $66 - $67 49%
Blue Cross Blue Shield $66 - $255 49%
UnitedHealthcare $66 - $238 49%
Wellcare $66 - $67 49%
Cigna $135 - $210 100%
Caresource North Carolina $140 - $142 103%
Aetna $175 - $283 129%
Atlantic Corporation Dba Atlantic Packaging $198 - $200 146%
Plotkin Health $210 - $212 155%
Amps $228 - $230 168%
Humana $273 - $276 201%
Medcost $298 - $333 220%
Primary Physician Care $308 - $312 227%
Beechstreet $315 - $319 232%
Multiplan $315 - $319 232%
Phcs $315 - $319 232%
Employers Choice Network $340 - $343 251%
Three Rivers Provider Network $340 - $343 251%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Silas Creek Parkway, Winston-Salem, NC 27103
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals