CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Carolina East Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $189
  • Cash Discount Price: $158
  • vs. Medicare Baseline: 1.39x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Carolina East Medical Center is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.39x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.
Cash / Self-Pay
$158

Average discount available for prompt cash payment at this facility.

Insurance Median
$189

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: $158 (117%)
Insurance Median: $189 (139%)
Cash: $158 (117% of Medicare)
Ins. Median: $189 (139% 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
Pamlico Co Jail-All Plans $70 - $71 52%
Humana $82 60%
Inclusive Health (Nchirp)-All Plans $82 60%
Tricare $82 - $266 60%
Craven Co. Jail Systems - All Plans $90 - $124 66%
UnitedHealthcare $92 - $189 68%
Medcost Ppo Ultra (Employees) $166 - $175 122%
Medcost Ppo Employees And Retirees $172 - $175 127%
Blue Cross Blue Shield $182 - $186 134%
Medcost Ppo City Employees $191 - $194 141%
Medcost Ppo County Employee $198 - $202 146%
Benefit Mgmt, Svcs-All Plans $223 - $226 164%
Aetna $232 - $236 171%
Medcost Benefit Svc-All Other Plans $232 - $235 171%
Acs Consult Svc Inc-All Plans $237 - $240 175%
Medcost Ppo Standard $237 - $240 175%
Cigna $238 - $242 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Neuse Blvd, New Bern, NC 28560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals