CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $309
Cash Discount Price: $483
vs. Medicare Baseline: 2.28x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mary Hitchcock Memorial Hospital is $309. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $483. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 2.28x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$483

Average discount available for prompt cash payment at this facility.

Insurance Median

$309

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: $483 (356%)

Insurance Median: $309 (228%)

Cash: $483 (356% of Medicare)

Ins. Median: $309 (228% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Amerihealth Caritas Nh	$58 - $300	43%
Beacon Health Strategies/Carelon	$62 - $323	46%
Wellsense Health Plan	$62 - $323	46%
Granite State Health Plan	$64 - $333	47%
Harvard Pilgrim Health Care Of Ne	$70 - $1,699	52%
Blue Cross Blue Shield	$94 - $2,307	69%
Martin'S Point Generations Advantage	$94 - $127	69%
Mvp	$94 - $1,774	69%
UnitedHealthcare	$94 - $2,034	69%
Aetna	$97 - $1,859	72%
Cigna	$97 - $1,817	72%
Martin'S Point Health Care	$97 - $914	72%
Wellcare Health Plans	$98 - $132	72%
Ambetter / Centene	$99 - $416	73%
Tufts Health Plan	$278 - $1,545	205%
Mass General Brigham Health Plan	$293 - $1,647	216%
Maine Community Health Options	$325 - $1,946	240%
Coventry	$444 - $2,304	327%
First Health/Hcvm	$444 - $2,304	327%
Phcs	$459 - $2,383	338%
Corvel	$469 - $2,436	346%
Ccmsi	$484 - $2,516	357%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $483.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mary Hitchcock Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.