CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Akron Children's Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $94
  • Cash Discount Price: $80
  • vs. Medicare Baseline: 0.69x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Akron Children's Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.69x the Medicare baseline. Located in 1 Perkins Square, Akron, OH.
Cash / Self-Pay
$80

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $80 (59%)
Insurance Median: $94 (69%)
Cash: $80 (59% of Medicare)
Ins. Median: $94 (69% 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
Healthplan (Hometown) $20 - $36 15%
Summacare $20 - $232 15%
Northern Ohio Handicapped Fund (Nohf $22 - $39 16%
Ohio Crippled Childrens Fund (Occf $22 - $39 16%
Amish Church Fund $30 - $54 22%
UnitedHealthcare $39 - $307 29%
Blue Cross Blue Shield $46 - $173 34%
Medben $46 - $81 34%
Mmo $46 - $242 34%
Autlcare $47 - $180 35%
Summa Health Employee $47 - $83 35%
Summacare Preferred Choice Network $47 - $84 35%
The Health Plan (Mountaineer Region) $48 - $86 35%
Avita-Osu Health Plan $49 - $88 36%
The Health Plan (Fna Hometown Health Network) $50 - $90 37%
Aetna $51 - $165 38%
Cigna $51 - $220 38%
Buckeye Community Health Plan $52 - $95 38%
Caresource $52 - $94 38%
Healthsmart (Fna Emerald Health Network) $52 - $94 38%
Humana $52 - $100 38%
Molina $52 - $95 38%
Amerihealth Caritas Ohio $53 - $98 39%
Embs/Thomas Steel $53 - $94 39%
Ohio Health Choice $53 - $94 39%
Phcs/Multiplan $53 - $94 39%
Enterprise Group Planning $54 - $96 40%
Prime Health Services $54 - $96 40%
Primenet $54 - $96 40%
Quality Care Partners $54 - $96 40%
Beechstreet $56 - $100 41%
Cofinity $56 - $101 41%
Health Reach Ohio Health Group $56 - $101 41%
Ohio Preferred Network $56 - $100 41%
Paramount $56 - $100 41%
Direct Care America $57 - $102 42%
First Health Network $57 - $102 42%
Cenpatico $95 70%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Perkins Square, Akron, OH 44308
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens