CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Banner Churchill Community Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $514
Cash Discount Price: $1,238
vs. Medicare Baseline: 3.79x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Banner Churchill Community Hospital is $514. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,238. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 3.79x the Medicare baseline. Located in 801 East Williams Avenue, Fallon, NV.

Cash / Self-Pay

$1,238

Average discount available for prompt cash payment at this facility.

Insurance Median

$514

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: $1,238 (913%)

Insurance Median: $514 (379%)

Cash: $1,238 (913% of Medicare)

Ins. Median: $514 (379% 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 379% of the Medicare baseline (a markup of 279%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$110 - $2,242	81%
Banner Health	$136 - $763	100%
Hometown Health	$136 - $2,266	100%
Silversummit Healthplan	$136 - $2,146	100%
Triwest Healthcare Alliance Corp - Va Ccn	$136 - $978	100%
UnitedHealthcare	$136 - $2,146	100%
Humana	$144 - $809	106%
Nevada Preferred Healthcare Providers	$382 - $2,146	282%
Blue Cross Blue Shield	$391 - $2,194	288%
Multiplan	$400 - $2,242	295%
Cigna	$401 - $2,251	296%
Coventry	$408 - $2,290	301%

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 $1,238.
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 Banner Churchill Community 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.