CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ohio State University State Health System

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $163
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ohio State University State Health System is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.20x the Medicare baseline. Located in 410 West 10Th Avenue, Columbus, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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%)
Insurance Median: $163 (120%)
Ins. Median: $163 (120% 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
Osu Health Plan $79 - $143 58%
Ohio Dept Of Health $94 69%
Ohio Ppo $95 - $128 70%
Odrc $103 - $116 76%
Healthspan $107 - $137 79%
Mmo $116 - $120 86%
Humana $117 - $132 86%
Cigna $140 - $157 103%
Aetna $163 - $238 120%
Ohiohealth $165 - $214 122%
Upper Ohio Valley $168 - $189 124%
Lifetrac $173 - $194 128%
Frontpath $203 - $229 150%
Multiplan $203 - $229 150%
Blue Cross Blue Shield $222 - $278 164%
Healthsmart $229 - $257 169%
United $304 224%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 410 West 10Th Avenue, Columbus, OH 43210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals