CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Columbia Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $125
  • Cash Discount Price: $161
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Columbia Memorial Hospital is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.92x the Medicare baseline. Located in 71 Prospect Avenue, Hudson, NY.
Cash / Self-Pay
$161

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $161 (119%)
Insurance Median: $125 (92%)
Cash: $161 (119% of Medicare)
Ins. Median: $125 (92% 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
Medicaid / KanCare $29 - $112 21%
Cdphp $41 - $198 30%
UnitedHealthcare $45 - $163 33%
Aetna $63 - $261 46%
Mvp $71 - $146 52%
Medicare (plans) $76 - $136 56%
Blue Cross Blue Shield $81 - $309 60%
Tricare $86 - $136 63%
Hamaspik $94 - $169 69%
Fidelis $96 - $149 71%
Cigna $103 - $146 76%
Blue Shield Highmark $120 - $133 88%
Magnacare $124 - $280 91%
Empire Plan Nyship $137 - $309 101%
Emblem Health Ghi $138 - $186 102%
Emblem $139 - $225 103%
Multiplan $145 - $327 107%
Mvp Commercial $161 - $363 119%
Nascentia Health Options $206 152%
Blue Shield $215 - $291 159%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Prospect Avenue, Hudson, NY 12534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals