CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Sanford Medical Center Bismarck

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $205
  • Cash Discount Price: $234
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Sanford Medical Center Bismarck is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.51x the Medicare baseline. Located in 300 N 7Th St, Bismarck, ND.
Cash / Self-Pay
$234

Average discount available for prompt cash payment at this facility.

Insurance Median
$205

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: $234 (173%)
Insurance Median: $205 (151%)
Cash: $234 (173% of Medicare)
Ins. Median: $205 (151% 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
Sanford Health Plan $93 - $124 69%
Sanford Health Plan Align $117 86%
Ucare $125 - $211 92%
Aetna $127 - $247 94%
Blue Cross Blue Shield $127 94%
Health Partners $127 - $134 94%
Medicare (plans) $127 94%
UnitedHealthcare $127 - $242 94%
Primewest $129 95%
Security Health Plan $161 119%
Medica $199 - $213 147%
Cigna $263 194%
First Choice Health Network $263 194%
Healthez $263 194%
Multiplan $263 194%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 N 7Th St, Bismarck, ND 58506
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals