CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Cleveland Clinic

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $134
  • Cash Discount Price: $224
  • vs. Medicare Baseline: 0.99x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Cleveland Clinic is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.99x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$224

Average discount available for prompt cash payment at this facility.

Insurance Median
$134

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: $224 (165%)
Insurance Median: $134 (99%)
Cash: $224 (165% of Medicare)
Ins. Median: $134 (99% 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
Oscar $28 - $220 21%
Aetna $38 - $826 28%
Ohcp $41 - $321 30%
Ohio Healthy $42 - $330 31%
Aultcare $46 - $355 34%
UnitedHealthcare $47 - $529 35%
Amish Community Aid Plan $48 - $372 35%
Paramount $51 - $74 38%
Buckeye $52 - $75 38%
Caresource $52 - $72 38%
Cc Ehp $52 - $174 38%
Zing Health $52 - $101 38%
Omas $53 - $413 39%
United $53 - $204 39%
Amerihealth $54 40%
Molina $54 - $75 40%
Healthsmart $58 - $454 43%
The Health Plan $58 - $454 43%
Summacare $60 - $164 44%
Phphi $64 - $496 47%
Upmc $64 - $496 47%
Clarity Health $69 - $537 51%
Gms $74 - $578 55%
Mmo $74 - $578 55%
Quality Care Partners $74 - $578 55%
Blue Cross Blue Shield $75 - $217 55%
United Bh $75 - $141 55%
Consociate Health $80 - $620 59%
Cigna $85 - $661 63%
Devoted Health $92 68%
Humana $92 - $147 68%
Valor $92 68%
Multiplan $95 - $743 70%
Three Rivers $95 - $743 70%
Usa Managed Care $95 - $743 70%
Communicare $96 71%
Perennial Health $99 73%
Pphp $99 - $101 73%
Php $104 77%
Medical Benefit Corp $121 89%
Parkview Health Plan $121 89%
Managed Care Services $130 96%
Community Health Alliance $138 102%
Frontpath $156 115%
Tertiary Care Network $156 115%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals