CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Harlan County Health System

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $129
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Harlan County Health System is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.95x the Medicare baseline. Located in 717 Brown St, Alma, NE.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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: $129 (95%)
Insurance Median: $129 (95%)
Cash: $129 (95% of Medicare)
Ins. Median: $129 (95% 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
Humana $20 - $282 15%
Medica Mcr Adv $56 - $225 41%
Medica Prime Solution $56 - $225 41%
Tricare $69 - $282 51%
Aetna $72 - $296 53%
Great Plains Mcr Adv-All Plans $72 - $296 53%
Medica Chi Health $80 - $147 59%
UnitedHealthcare $80 - $199 59%
Medica Chi Aco - All Other Plans $94 - $154 69%
Medica Choice $94 - $161 69%
Blue Cross Blue Shield $98 - $158 72%
Ohara Llc Wc- All Plans $98 - $189 72%
Medica Ifb Aco $99 - $155 73%
Medica Ifb Open Access $99 - $186 73%
Phcs/Multiplan-All Plans $101 - $240 74%
Ambetter / Centene $203 150%
Healthy Blue Mcaid-All Plans $209 154%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 717 Brown St, Alma, NE 68920
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals