CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Artesia General Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $229
Cash Discount Price: $217
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Artesia General Hospital is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $217. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.69x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$217

Average discount available for prompt cash payment at this facility.

Insurance Median

$229

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: $217 (160%)

Insurance Median: $229 (169%)

Cash: $217 (160% of Medicare)

Ins. Median: $229 (169% 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.

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
Presbyterian Health Plan	$35 - $97	26%
Zelis	$78 - $185	58%
Blue Cross Blue Shield	$79 - $222	58%
UnitedHealthcare	$79 - $92	58%
Humana	$85 - $101	63%
Triwest	$90 - $326	66%
Geha	$92 - $296	68%
Health Net Federal Services	$92	68%
Molina Healthcare Of New Mexico	$92 - $129	68%
New Mexico Health Connections	$97 - $222	72%
First Health	$126 - $333	93%
Cimarron Advantage	$129	95%
Healthsmart	$129 - $214	95%
Cigna	$145 - $333	107%
Omni Networks	$169 - $259	125%
Multiplan	$181 - $337	133%
Providence Risk & Insurance Services	$200 - $352	147%
National Preferred Provider Network	$226 - $229	167%
Three Rivers Provider Network	$244 - $278	180%
Galaxy Health	$293 - $333	216%
One Health Plan	$293 - $333	216%
United Payors & United Providers	$303 - $344	223%

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 $217.
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 Artesia General 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.