CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Lake Health Beachwood Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $123
Cash Discount Price: $142
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Lake Health Beachwood Medical Center is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.91x the Medicare baseline. Located in 25501 Chagrin Boulevard, Beachwood, OH.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $142 (105%)

Insurance Median: $123 (91%)

Cash: $142 (105% of Medicare)

Ins. Median: $123 (91% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aultcare	$31	23%
Jp Farley	$42	31%
Amish Aid Community Plan	$87	64%
Amish Church Fund And Workers Aid Plan	$87	64%
Buckeye Plain Ministries	$87	64%
Clarity	$91	67%
Summacare	$91 - $119	67%
Christian Healthcare Ministries	$94	69%
Immergrun	$94	69%
Sunrise Plan Communities	$94	69%
Aetna	$119 - $213	88%
Blue Cross Blue Shield	$119 - $238	88%
Cigna	$119 - $360	88%
Devoted Health	$119	88%
Humana	$119	88%
Medical Mutual Of Ohio	$119	88%
Molina	$119 - $131	88%
Primetime Health Plan	$119	88%
The Health Plan	$119	88%
UnitedHealthcare	$119 - $302	88%
Wellcare By Allwell	$119	88%
Healthsmart	$123	91%
Ohio Health Choice	$123 - $170	91%
Paramount	$123	91%
Perennial Advantage Of Ohio	$125	92%
Valor Health Plans	$125	92%
Beech Street	$151 - $170	111%
Ohio Preferred Network	$151 - $170	111%
First Health	$157	116%
Century Health Network	$161	119%
Private Healthcare System	$163	120%
Configurenet	$170	125%
Fortified Provider Network	$170	125%
Multiplan	$170	125%
Ambetter / Centene	$215	159%
Caresource	$215	159%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $142.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lake Health Beachwood Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.