CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Carolinas Medical Center/Behav Health

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $124
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Carolinas Medical Center/Behav Health is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.91x the Medicare baseline. Located in 1000 Blythe Blvd, Charlotte, NC.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$124

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%)
Insurance Median: $124 (91%)
Ins. Median: $124 (91% 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
Partners $62 - $77 46%
Sandhills $62 46%
Amerihealth Caritas $78 58%
Carolina Complete Health $78 58%
Healthy Blue $78 58%
Trillium $78 58%
UnitedHealthcare $78 - $153 58%
Vaya $78 58%
Wellcare $78 58%
Alliance $79 58%
Blue Cross Blue Shield $90 - $154 66%
Cigna $90 - $125 66%
Humana $92 - $122 68%
Aetna $93 - $269 69%
Ortho Carolina $113 - $149 83%
Choicecare $124 91%
Employers Health Network $147 108%
Medcost $165 122%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Blythe Blvd, Charlotte, NC 28203
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals