CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Arthur G James Cancer Hospital and Research Institute

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $142
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Arthur G James Cancer Hospital and Research Institute is $142. 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 1.05x the Medicare baseline. Located in 460 W 10Th Ave, Columbus, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$142

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: $142 (105%)
Ins. Median: $142 (105% 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
Mmo $42 - $227 31%
Healthspan $56 - $5,413 41%
Medicare (plans) $56 - $5,467 41%
Medigold $56 - $63 41%
Upper Ohio Valley $56 - $5,413 41%
Humana $57 - $5,521 42%
Medicaid / KanCare $64 - $99 47%
Aetna $68 - $5,388 50%
United $71 - $260 52%
Caresource $84 - $141 62%
Molina $84 - $5,388 62%
Odrc $88 - $116 65%
Blue Cross Blue Shield $93 - $271 69%
Buckeye Community $94 - $140 69%
Ohio Dept Of Health $94 - $4,289 69%
Amerihealth $95 - $154 70%
Osu Health Plan $116 - $189 86%
Cigna $140 - $207 103%
Lifetrac $165 - $194 122%
Ohio Ppo $167 - $188 123%
Ohiohealth $183 - $209 135%
Frontpath $203 - $229 150%
Healthsmart $229 - $257 169%
Multiplan $236 - $266 174%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 460 W 10Th Ave, Columbus, OH 43210
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL