CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ohio Valley Surgical Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $120
  • Cash Discount Price: $203
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ohio Valley Surgical Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $203. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.88x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$203

Average discount available for prompt cash payment at this facility.

Insurance Median
$120

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: $203 (150%)
Insurance Median: $120 (88%)
Cash: $203 (150% of Medicare)
Ins. Median: $120 (88% 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 $120 88%
Geha $120 88%
Genworth $120 88%
Mail Handlers $120 88%
Meritain $120 88%
Meritain Heatlh $120 88%
Mhbp $120 88%
Ngs Coresource $120 88%
Nippon Life $120 88%
Pacific Source $120 88%
Personify Health $120 88%
Mmoh $152 - $155 112%
Mmo Cin. Hmo $155 114%
Mmoh (Supermed) $155 114%
Medicare (plans) $203 150%
Luminare Health $304 224%
Medben $304 224%
Ohio Health $304 224%
Preferred Health $304 224%
Blue Cross Blue Shield $333 246%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals