CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Alliancehealth Durant

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $7,302
Cash Discount Price: $1,209
vs. Medicare Baseline: 53.85x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Alliancehealth Durant is $7,302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,209. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 53.85x the Medicare baseline. Located in 1800 University Boulevard, Durant, OK.

Cash / Self-Pay

$1,209

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,302

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: $1,209 (892%)

Insurance Median: $7,302 (5385%)

Cash: $1,209 (892% of Medicare)

Ins. Median: $7,302 (5385% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 5385% of the Medicare baseline (a markup of 5285%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Veterans Eval Services	$118	87%
Node Us Dept Of Labor	$134	99%
Healthchoice	$197	145%
Self Pay	$1,410	1040%
Blue Cross Blue Shield	$1,481	1092%
Cigna	$2,709	1998%
UnitedHealthcare	$2,931	2162%
Healthcare Highways	$3,354	2473%
Customer Linx	$6,043	4456%
Phcs Savility	$7,050	5199%
Aetna	$7,554	5571%
First Health	$7,554	5571%
Healthsmart	$7,655	5645%
Multiplan Complementary	$8,058	5942%
Multiplan Primary	$8,058	5942%
Prime Health Services	$8,058	5942%
One Health Plan	$8,561	6313%
Preferred Community Choice Ppo	$8,561	6313%
Comprehensive Medical Care	$9,065	6685%

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 $1,209.
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 Alliancehealth Durant 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.