CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Union Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $94
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 0.69x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Union Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.69x the Medicare baseline. Located in 659 Boulevard, Dover, OH.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $112 (83%)
Insurance Median: $94 (69%)
Cash: $112 (83% of Medicare)
Ins. Median: $94 (69% 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
Healthsmart $14 - $454 10%
Phphi $15 - $496 11%
Upmc $15 - $496 11%
Gms $18 - $578 13%
Mmo $18 - $578 13%
Summacare $18 - $578 13%
Aetna $19 - $826 14%
Consociate Health $19 - $620 14%
Multiplan $22 - $743 16%
Oscar $28 - $220 21%
Ohcp $41 - $321 30%
Buckeye $49 - $60 36%
Molina $49 - $63 36%
Caresource $52 - $60 38%
Zing Health $52 - $101 38%
Omas $53 - $413 39%
United $53 - $170 39%
Amerihealth $54 - $66 40%
The Health Plan $57 - $149 42%
Blue Cross Blue Shield $63 - $169 46%
United Bh $75 - $141 55%
Amish Community Aid Plan $78 - $86 58%
Aultcare $78 - $105 58%
Cigna $92 - $155 68%
Humana $92 68%
Valor $92 68%
Ohio Healthy $93 69%
Communicare $96 71%
Perennial Health $99 73%
Pphp $99 - $101 73%
Cc Ehp $103 - $129 76%
Php $104 77%
Medical Benefit Corp $121 89%
Managed Care Services $130 96%
Frontpath $156 115%
Tertiary Care Network $156 115%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 659 Boulevard, Dover, OH 44622
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals