CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Cleveland Clinic Children's Hospital for Rehab

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $105
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 0.77x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Cleveland Clinic Children's Hospital for Rehab is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.77x the Medicare baseline. Located in 2801 Martin Luther King, Jr Drive, Cleveland, OH.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $112 (83%)
Insurance Median: $105 (77%)
Cash: $112 (83% of Medicare)
Ins. Median: $105 (77% 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 $49 - $173 36%
Oscar $52 - $67 38%
Aultcare $59 44%
Amish Community Aid Plan $78 - $86 58%
Ohcp $84 62%
Summacare $86 - $87 63%
Buckeye $94 - $115 69%
Healthsmart $95 70%
UnitedHealthcare $95 - $127 70%
United $99 - $107 73%
Paramount $103 76%
Php $104 77%
Phphi $104 77%
The Health Plan $104 77%
Upmc $104 77%
Blue Cross Blue Shield $105 - $131 77%
Molina $105 77%
Caresource $107 79%
Amerihealth $110 81%
Gms $121 89%
Medical Benefit Corp $121 89%
Quality Care Partners $121 89%
Cc Ehp $123 91%
Consociate Health $130 96%
Managed Care Services $130 96%
Ohio Healthy $138 102%
Multiplan $156 115%
Three Rivers $156 115%
Cigna $161 119%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2801 Martin Luther King, Jr Drive, Cleveland, OH 44104
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens