CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Sunrise Hospital and Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $115
  • Cash Discount Price: $426
  • vs. Medicare Baseline: 0.85x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Sunrise Hospital and Medical Center is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $426. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.85x the Medicare baseline. Located in 3186 S Maryland Pkwy, Las Vegas, NV.
Cash / Self-Pay
$426

Average discount available for prompt cash payment at this facility.

Insurance Median
$115

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: $426 (314%)
Insurance Median: $115 (85%)
Cash: $426 (314% of Medicare)
Ins. Median: $115 (85% 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
Amerigroup $35 - $105 26%
Health Plan Nevada $35 - $111 26%
Community Care Health $36 - $72 27%
Molina Healthcare $36 - $75 27%
Sierra Hpn $36 - $72 27%
Molina $37 - $116 27%
Silver Summit $37 - $156 27%
Ambetter / Centene $38 - $326 28%
Humana $42 - $129 31%
Blue Cross Blue Shield $55 - $1,552 41%
United $55 - $324 41%
Culinary Health Fund $60 - $187 44%
Healthcare Partners Of Nv $91 - $166 67%
Aetna $93 - $469 69%
Alignment Health Plan $93 - $124 69%
Caremore $98 - $131 72%
Hometown Health Providers $107 - $776 79%
Cigna $110 - $263 81%
Sierra $120 - $168 88%
Multiplan $124 - $1,133 91%
Legacy Provider Network $157 116%
Corvel $165 - $176 122%
Comp-Med Workers Comp $169 125%
Olympus Medsave Usa $174 - $1,164 128%
Select Health $186 - $358 137%
Health Services Coalition $211 156%
Imperial Nv $233 172%
Prominence Healthfirst $466 344%
Cmn Global $652 481%
Nv Health & Welfare Trust $931 687%
First Health $1,024 - $1,242 755%
Medcare International $1,164 858%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3186 S Maryland Pkwy, Las Vegas, NV 89109
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals