CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Sunrise Hospital and Medical Center

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$113

about 0.8× the $136 Medicare rate · typically $81–$203

modeled estimate · not a bill or quote

What this hospital charges insurers

$111

About the fair price

about $2 under the fair price · 0.8× Medicare

Medicare pays $136 Fair price $113 This hospital $111 Cash price $426 Hospital's list price $426

How we calculate the fair BaseRate →

How this hospital compares to other NV hospitals

Highest price of the 9 NV hospitals we have prices for — worth calling around.

Cheapest $37 Priciest $111

Black dot = this hospital, among the 9 NV hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Office visit, established patient (30-39 min) is about $113 (about 0.8× the $136 Medicare rate). Sunrise Hospital and Medical Center charges insurers about $111, or about $426 in cash — about the fair price. Located in Las Vegas, NV.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$55 - $324	41%
Blue Cross Blue Shieldmajor	$55 - $1,552	41%
Aetnamajor	$93 - $469	69%
Cignamajor	$110 - $263	81%
Humanamajor	$42 - $129	31%
Ambetter (Centene)	$38 - $326	28%
Amerigroup	$35 - $105	26%
Molina	$36 - $116	27%
SelectHealth	$186 - $358	137%
+ 18 smaller / regional plans	$35 - $1,164

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 426), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99214.

Insurance Before you use insurance

Call your insurance company to confirm Sunrise Hospital and Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 99214.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Sunrise Hospital and Medical Center

Compare: Office visit, established patient (30-39 min) at other NV hospitals

Insurance negotiated median for the same procedure, sorted lowest first.