CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: UNM Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $84
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 0.62x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at UNM Hospital is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.62x the Medicare baseline. Located in 2211 Lomas Boulevard Ne, Albuquerque, NM.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $94 (69%)
Insurance Median: $84 (62%)
Cash: $94 (69% of Medicare)
Ins. Median: $84 (62% 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 $46 - $84 34%
Humana $76 56%
Blue Cross Blue Shield $79 - $84 58%
Aetna $84 62%
Alamo Navajo School Board $84 62%
Indian Health Abq $84 62%
Kewa Pueblo Health Corporation $84 62%
Pueblo Of Isleta $84 62%
Pueblo Of Jemez $84 62%
Pueblo Of Sandia $84 62%
Devoted Health $101 74%
Christus $126 93%
Albuquerque Public Schools $168 124%
Presbyterian Network $168 124%
Christus Health Exchange Plan $189 139%
Imperial Health Exchange $206 152%
Molina $206 152%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2211 Lomas Boulevard Ne, Albuquerque, NM 87106
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals