CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Atlanticare Regional Medical Center - City Campus

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $333
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.46x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Atlanticare Regional Medical Center - City Campus is $333. 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 2.46x the Medicare baseline. Located in 1925 Pacific Avenue, Atlantic City, NJ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$333

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: $333 (246%)
Ins. Median: $333 (246% 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 246% of the Medicare baseline (a markup of 146%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Americhoice $54 40%
UnitedHealthcare $54 - $299 40%
Wellcare $58 43%
Horizon $59 - $295 44%
Self Pay $63 46%
Health Partners Plan $105 77%
Amerigroup $109 80%
Magnacare $168 - $379 124%
Cigna $177 - $212 131%
Devoted Health Plan $210 155%
Evernorth $210 - $756 155%
Qualcare Commercial $210 155%
Great West Life $212 156%
Aetna $242 - $348 178%
Amerihealth $271 - $354 200%
Active Care Plus $274 202%
First Mco $274 202%
Mutual Of Omaha $274 202%
Qualcare Wc $274 202%
Consumer Health Network (Chn) $295 - $379 218%
Donio Trucking $295 218%
Devon/ Ullicare $316 233%
Oxford $316 233%
Coventry Health Care $337 249%
Private Healthcare System (Phcs) $337 249%
Blue Cross Blue Shield $346 255%
Health Payors Org $358 264%
Health South $358 264%
Metrahealth Of Nj $358 264%
Prime Health Services $358 264%
Three Rivers Provider Network (Trpn) $358 264%
Active Care Nj Pip $379 279%
Beech Street $379 279%
Choice Care $379 279%
Department Of Corrections $379 279%
Galaxy Health Network $379 279%
Health Network Inc $379 279%
Intergroup Preferred Program $379 279%
Mcs Commercial $379 279%
Metracomp $379 279%
Multiplan $379 279%
Provider Select, Inc $379 279%
Atlantis Health Plan $389 287%
Master Care Inc $389 287%
Advance Healthcare System $400 295%
Community Care Network $400 295%
Health Network America $400 295%
Mcsi/Mrsi No Fault $400 295%
Mcsi/Mrsi Worker'S Comp $400 295%
National Health Plan $400 295%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1925 Pacific Avenue, Atlantic City, NJ 08401
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals