Office visit, established patient (30-39 min)
Facility: Rainbow Babies and Childrens Hospital
Billing Code: 99214 (CPT)
This hospital's typical commercial price is $130 compared to the $101 fair price benchmark.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Highest price of the 9 OH hospitals we have prices for — worth calling around.
Black dot = this hospital, among the 9 OH hospitals with a price for this procedure. Full list below.
A fair price for a Office visit, established patient (30-39 min) is about $101 (about 0.7× the $136 Medicare rate). Rainbow Babies and Childrens Hospital charges insurers about $130, or about $285 in cash — above the fair price. Located in Cleveland, OH.
This price is above the fair BaseRate — you may be able to pay less
Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $101. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
5 of 6 major insurers have a published price at this hospital
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $119 - $395 | 88% |
| Blue Cross Blue Shieldmajor | $102 - $365 | 75% |
| Aetnamajor | $44 - $451 | 32% |
| Cignamajor | $120 - $383 | 88% |
| Humanamajor | $130 | 96% |
| Ambetter (Centene) | $109 - $318 | 80% |
| CareSource | $105 - $306 | 77% |
| Devoted Health | $130 | 96% |
| Health Net | $165 - $482 | 122% |
| Medical Mutual | $65 - $451 | 48% |
| Molina | $130 | 96% |
| Paramount | $134 | 99% |
| WellCare | $130 | 96% |
| + 19 smaller / regional plans | $97 - $510 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Rainbow Babies and Childrens Hospital
Compare: Office visit, established patient (30-39 min) at other OH hospitals
- Uhhs Memorial Hospital of Geneva · Geneva $37
- University Hospitals Conneaut Medical Center · Conneaut $42
- Cincinnati Children's Hospital Medical Center · Cincinnati $57
- Lutheran Hospital · Cleveland $59
- Marymount Hospital · Garfield Heights $59
- Cleveland Clinic Avon Hospital · Avon $59
- Medina Hospital · Medina $61
- Fairview Hospital · Cleveland $62
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Rainbow Babies and Childrens Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $138
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $138).
Self-Pay Cash Rate ($285) Beats Your Bill
Rainbow Babies and Childrens Hospital's published 45 CFR § 180 self-pay cash rate is $285 (vs. $130 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $101 Fair BaseRate ($136 Medicare)
Your bill ($381) is $280 above the denoised Fair BaseRate ($101) and 2.8× the $136 Medicare rate.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.