CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Memorial Community Hospital & Health System

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $213
  • Cash Discount Price: $462
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Memorial Community Hospital & Health System is $213. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $462. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.57x the Medicare baseline. Located in 810 North 22Nd St, Blair, NE.
Cash / Self-Pay
$462

Average discount available for prompt cash payment at this facility.

Insurance Median
$213

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: $462 (341%)
Insurance Median: $213 (157%)
Cash: $462 (341% of Medicare)
Ins. Median: $213 (157% 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
UnitedHealthcare $55 - $862 41%
Ne Total Care Mcaid-All Other Plans $58 - $426 43%
Medicaid / KanCare $59 - $452 44%
Blue Cross Blue Shield $68 - $871 50%
Tricare $80 - $454 59%
Ne Total Care Comm Exch Op/Profee Only $85 63%
Aetna $145 - $180 107%
Medica Comm-All Other Plans $149 - $825 110%
Midlands Choice-All Plans $182 134%
Multiplan (Phcs)-All Plans $231 - $889 170%
Humana $458 - $816 338%
Medica Mcr Adv $481 355%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 810 North 22Nd St, Blair, NE 68008
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals