CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Novant Health Presbyterian Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $210
  • Cash Discount Price: $166
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Novant Health Presbyterian Medical Center is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.55x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.
Cash / Self-Pay
$166

Average discount available for prompt cash payment at this facility.

Insurance Median
$210

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: $166 (122%)
Insurance Median: $210 (155%)
Cash: $166 (122% of Medicare)
Ins. Median: $210 (155% 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 $50 - $83 37%
Nc Department Of Public Safety $50 - $83 37%
Amerihealth $51 - $84 38%
Blue Cross Blue Shield $51 - $341 38%
UnitedHealthcare $51 - $277 38%
Wellcare $51 - $84 38%
Caresource North Carolina $95 - $156 70%
Atlantic Corporation Dba Atlantic Packaging $132 - $218 97%
Aetna $144 - $379 106%
Cigna $148 - $244 109%
Amps $158 - $261 117%
Plotkin Health $172 - $284 127%
Medcost $204 - $356 150%
Humana $207 - $341 153%
Primary Physician Care $212 - $351 156%
Multiplan $215 - $356 159%
Phcs $215 - $356 159%
Employers Choice Network $278 - $460 205%
Three Rivers Provider Network $278 - $460 205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Hawthorne Lane Box 33549, Charlotte, NC 28233
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals