CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Howard County Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $144
  • Cash Discount Price: $254
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Howard County Medical Center is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.06x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.
Cash / Self-Pay
$254

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

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: $254 (187%)
Insurance Median: $144 (106%)
Cash: $254 (187% of Medicare)
Ins. Median: $144 (106% 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
Nebraska Total Care $58 - $127 43%
UnitedHealthcare $58 - $287 43%
Molina Healthcare $59 - $127 44%
Humana $75 - $88 55%
Aetna $86 - $241 63%
Blue Cross Blue Shield $86 - $562 63%
Great Plains $86 - $145 63%
Medica Chi $86 - $145 63%
Tricare $88 - $190 65%
Medica Standard Premier $89 66%
Medica Elevate $90 - $175 66%
Nebraska Total Care - Wellcare $91 67%
Medica Chi Aco $136 - $231 100%
Medica Choice National $136 - $231 100%
Medica Ifb Aco $144 - $244 106%
Medica Ifb Open Access $144 - $244 106%
Oscar Health $154 114%
Ambetter / Centene $176 130%
Beshp $176 130%
Midland'S Choice $243 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: P O Box 406, 1113 Sherman St, St Paul, NE 68873
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals