CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Euclid Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $87
Cash Discount Price: $112
vs. Medicare Baseline: 0.64x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Euclid Hospital is $87. 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 0.64x the Medicare baseline. Located in 18901 Lake Shore Boulevard, Euclid, OH.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $87 (64%)

Cash: $112 (83% of Medicare)

Ins. Median: $87 (64% 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.

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	$38 - $173	28%
Oscar	$52 - $67	38%
UnitedHealthcare	$59 - $107	44%
Summacare	$61 - $67	45%
Paramount	$64	47%
Blue Cross Blue Shield	$66 - $138	49%
Buckeye	$66	49%
Molina	$66	49%
United Bh	$66	49%
Caresource	$67	49%
Cc Ehp	$67 - $69	49%
United	$67	49%
Amerihealth	$69	51%
Aultcare	$74	55%
Amish Community Aid Plan	$78 - $86	58%
Ohcp	$84	62%
Omas	$86	63%
Mmo	$93 - $104	69%
Ohio Healthy	$93	69%
Healthsmart	$95	70%
Php	$104	77%
The Health Plan	$104	77%
Upmc	$104	77%
Gms	$121	89%
Medical Benefit Corp	$121	89%
Quality Care Partners	$121	89%
Consociate Health	$130	96%
Managed Care Services	$130	96%
Humana	$147	108%
Frontpath	$156	115%
Multiplan	$156	115%
Tertiary Care Network	$156	115%
Three Rivers	$156	115%

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 $112.
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 Euclid 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.