CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Mercy Hospital Watonga, Inc
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $161
- Cash Discount Price: $175
- vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercy Hospital Watonga, Inc is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $175. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.19x the Medicare baseline. Located in 500 North Clarence Nash Boulevard, Watonga, OK.
Cash / Self-Pay
$175
Average discount available for prompt cash payment at this facility.
Insurance Median
$161
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: $175 (129%)
Insurance Median: $161 (119%)
Cash: $175 (129% of Medicare)
Ins. Median: $161 (119% 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 | $81 - $221 | 60% |
| Ambetter / Centene | $81 - $111 | 60% |
| Blue Cross Blue Shield | $81 - $145 | 60% |
| Cherokee Nation Health Serv Contracted [320066] | $81 - $103 | 60% |
| Cross Timbers Hospice [20098] | $81 - $103 | 60% |
| Dept Of Veteran Affairs Contracted [320106] | $81 - $103 | 60% |
| Elara Caring Aspire Hospice Contracted [320433] | $81 - $103 | 60% |
| Elara Caring Aspire Hospice [20433] | $81 - $103 | 60% |
| Halo Hcr Inc Hospice Contracted [320432] | $81 - $103 | 60% |
| Halo Hcr Inc Hospice [20432] | $81 - $103 | 60% |
| Home State Health Plan Contracted [320187] | $81 - $111 | 60% |
| Humana | $81 - $113 | 60% |
| Independent Health [20197] | $81 - $103 | 60% |
| Indian Health Service Contracted [320198] | $81 - $103 | 60% |
| Kindful Hospice Contracted [320434] | $81 - $103 | 60% |
| Kindful Hospice [20434] | $81 - $103 | 60% |
| Medicaid / KanCare | $81 - $113 | 60% |
| Medical Associates Health [20444] | $81 - $103 | 60% |
| Medicare (plans) | $81 - $151 | 60% |
| Mercy Hospice Okc [20252] | $81 - $103 | 60% |
| Novasys Contracted [320285] | $81 - $111 | 60% |
| Provider Partners Health Plans Contracted [320450] | $81 - $103 | 60% |
| Qual Choice Contracted [320325] | $81 - $103 | 60% |
| Tribute Health Plan Mcr Contracted [320338] | $81 - $103 | 60% |
| Tricare | $81 - $103 | 60% |
| UnitedHealthcare | $81 - $230 | 60% |
| Globalhealth Contracted [320145] | $82 - $105 | 60% |
| Cigna | $83 - $246 | 61% |
| Webtpa Contracted [320417] | $104 - $122 | 77% |
| Medica Contracted [320239] | $112 - $151 | 83% |
| Aither Health Contracted [320449] | $148 - $246 | 109% |
| Mercy Benefit Admin Contracted [320251] | $148 - $246 | 109% |
| Quik Trip Contracted [320447] | $148 - $174 | 109% |
| Show-Me Health Administrators Contracted [320483] | $148 - $174 | 109% |
| Benefit Management Contracted [320052] | $161 - $218 | 119% |
| Healthsmart Accel Contracted [320183] | $173 - $203 | 128% |
| Osma Health Contracted [320292] | $173 - $203 | 128% |
| Healthcare Highways Plus Contracted [320175] | $185 - $218 | 136% |
| Preferred Community Choice Contracted [320311] | $185 - $218 | 136% |
| Private Health Care Systems Contracted [320320] | $185 - $232 | 136% |
| United Medical Resources Contracted [320454] | $196 - $230 | 145% |
| Health Choice Contracted [320166] | $197 | 145% |
| Multiplan Contracted [320270] | $198 - $261 | 146% |
| First Health Contracted [320128] | $200 - $235 | 147% |
| Auxiant Contracted [320462] | $210 - $246 | 155% |
| Ebms Contracted [320493] | $210 - $246 | 155% |
| Healthlink Contracted [320179] | $210 - $246 | 155% |
| Healthsmart Preferred Care Contracted [320184] | $210 - $246 | 155% |
| Imagine 360 Contracted [320494] | $210 - $246 | 155% |
| Reflect Health Contracted [320492] | $210 - $246 | 155% |
| Yuzu Health Contracted [320521] | $210 - $246 | 155% |