CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Children's Nebraska

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $121
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Children's Nebraska is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.89x the Medicare baseline. Located in 8200 Dodge St, Omaha, NE.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

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%)
Insurance Median: $121 (89%)
Ins. Median: $121 (89% 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
Medicaid / KanCare $24 - $139 18%
Wellpoint $24 - $67 18%
Molina (Iowa) $25 - $69 18%
Sanford Health Plan $100 - $394 74%
Wellmark $117 - $381 86%
UnitedHealthcare $119 - $376 88%
Aetna $139 - $394 103%
Avera $146 - $193 108%
Ambetter / Centene $169 - $314 125%
Centivo $172 - $381 127%
Midlands Choice Chi $186 - $314 137%
Blue Cross Blue Shield $204 - $358 150%
Health Partners $216 - $288 159%
Midlands Choice $216 - $394 159%
Midlands Choice Elevate $216 - $358 159%
Avera Health Plan $381 281%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8200 Dodge St, Omaha, NE 68114
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens