CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Marymount Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $93
  • 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 Marymount Hospital is $93. 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 12300 McCracken Road, Garfield Heights, OH.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $93 (69%)
Cash: $112 (83% of Medicare)
Ins. Median: $93 (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
Aetna $38 - $173 28%
Oscar $52 - $67 38%
Zing Health $52 38%
UnitedHealthcare $53 - $107 39%
Paramount $57 42%
Blue Cross Blue Shield $58 - $138 43%
Buckeye $58 43%
Molina $58 43%
Summacare $58 - $64 43%
Caresource $59 44%
United $59 44%
United Bh $59 44%
Amerihealth $61 45%
Cc Ehp $67 - $69 49%
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%
Phphi $104 77%
The Health Plan $104 77%
Upmc $104 77%
Devoted Health $112 83%
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%
Cigna $161 119%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12300 McCracken Road, Garfield Heights, OH 44125
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals