CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Mercy Hospital Logan County
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $159
- Cash Discount Price: $177
- vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercy Hospital Logan County is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.17x the Medicare baseline. Located in 200 S Academy Rd, Guthrie, OK.
Cash / Self-Pay
$177
Average discount available for prompt cash payment at this facility.
Insurance Median
$159
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: $177 (131%)
Insurance Median: $159 (117%)
Cash: $177 (131% of Medicare)
Ins. Median: $159 (117% 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 |
|---|---|---|
| Tricare | $65 - $74 | 48% |
| Cherokee Nation Health Serv Contracted [320066] | $67 - $76 | 49% |
| Cross Timbers Hospice [20098] | $67 - $76 | 49% |
| Elara Caring Aspire Hospice Contracted [320433] | $67 - $76 | 49% |
| Elara Caring Aspire Hospice [20433] | $67 - $76 | 49% |
| Halo Hcr Inc Hospice Contracted [320432] | $67 - $76 | 49% |
| Halo Hcr Inc Hospice [20432] | $67 - $76 | 49% |
| Indian Health Service Contracted [320198] | $67 - $76 | 49% |
| Kindful Hospice Contracted [320434] | $67 - $76 | 49% |
| Kindful Hospice [20434] | $67 - $76 | 49% |
| Mercy Hospice Okc [20252] | $67 - $76 | 49% |
| UnitedHealthcare | $67 - $209 | 49% |
| Aetna | $69 - $175 | 51% |
| Blue Cross Blue Shield | $69 - $158 | 51% |
| Dept Of Veteran Affairs Contracted [320106] | $69 - $81 | 51% |
| Humana | $69 - $113 | 51% |
| Independent Health [20197] | $69 - $81 | 51% |
| Medical Associates Health [20444] | $69 - $81 | 51% |
| Medicare (plans) | $69 - $149 | 51% |
| Provider Partners Health Plans Contracted [320450] | $69 - $81 | 51% |
| Qual Choice Contracted [320325] | $69 - $81 | 51% |
| Tribute Health Plan Mcr Contracted [320338] | $69 - $81 | 51% |
| Globalhealth Contracted [320145] | $70 - $82 | 52% |
| Cigna | $71 - $253 | 52% |
| Ambetter / Centene | $78 - $89 | 58% |
| Home State Health Plan Contracted [320187] | $78 - $89 | 58% |
| Medicaid / KanCare | $78 - $113 | 58% |
| Novasys Contracted [320285] | $78 - $89 | 58% |
| Health Choice Contracted [320166] | $93 | 69% |
| Webtpa Contracted [320417] | $110 - $125 | 81% |
| Medica Contracted [320239] | $130 - $149 | 96% |
| Aither Health Contracted [320449] | $157 - $253 | 116% |
| Auxiant Contracted [320462] | $157 - $253 | 116% |
| Federal Medical Center Contracted [320127] | $157 - $179 | 116% |
| Healthlink Contracted [320179] | $157 - $253 | 116% |
| Healthscope Contracted [320182] | $157 - $179 | 116% |
| Mercy Benefit Admin Contracted [320251] | $157 - $253 | 116% |
| Point C Contracted [320238] | $157 - $179 | 116% |
| Preferred Health Plan Contracted [320522] | $157 - $179 | 116% |
| Show-Me Health Administrators Contracted [320483] | $157 - $179 | 116% |
| United Medical Resources Contracted [320454] | $157 - $209 | 116% |
| Osma Health Contracted [320292] | $183 - $209 | 135% |
| United Behavioral Health Contracted [320390] | $183 - $209 | 135% |
| Benefit Management Contracted [320052] | $196 - $268 | 145% |
| Globalhealth Contracted [320144] | $196 - $224 | 145% |
| Healthcare Highways Plus Contracted [320175] | $196 - $224 | 145% |
| Private Health Care Systems Contracted [320320] | $196 - $238 | 145% |
| Community Care Contracted [320080] | $200 | 147% |
| First Health Contracted [320128] | $204 - $233 | 150% |
| Multiplan Contracted [320270] | $209 - $268 | 154% |
| Ebms Contracted [320493] | $222 - $253 | 164% |
| Imagine 360 Contracted [320494] | $222 - $253 | 164% |
| Preferred Community Choice Contracted [320311] | $222 - $253 | 164% |
| Reflect Health Contracted [320492] | $222 - $253 | 164% |
| Yuzu Health Contracted [320521] | $222 - $253 | 164% |