CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ohiohealth Morrow County Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $116
Cash Discount Price: $109
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ohiohealth Morrow County Hospital is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.86x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $109 (80%)

Insurance Median: $116 (86%)

Cash: $109 (80% of Medicare)

Ins. Median: $116 (86% 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
Blue Cross Blue Shield	$57 - $156	42%
Medicare (plans)	$57 - $76	42%
UnitedHealthcare	$57 - $165	42%
Aetna	$58 - $174	43%
Humana	$58 - $188	43%
Caresource Marketplace - All Other Plans	$72 - $93	53%
Medicaid / KanCare	$84 - $86	62%
Amerihealth Caritas - All Plans	$87	64%
Medical Mutual Of Ohio Marketplace	$116 - $151	86%
Ohiohealthy Network - All Other Plans	$116 - $151	86%
Ohiohealthy Preferred	$116 - $151	86%
Medical Mutual Of Ohio Comm - All Other Plans	$125 - $163	92%
Medical Mutual Of Ohio - Admin Serv	$131 - $172	97%
Molina Exchange - All Other Plans	$139	103%
Phcs - All Plans	$142 - $186	105%
Cigna	$145 - $190	107%
Multiplan - All Plans	$147 - $192	108%
Healthstar Comm - All Plans	$148 - $194	109%
Beech Street - All Plans	$150 - $196	111%

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 $109.
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 Ohiohealth Morrow County Hospital 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.