CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Carnegie Tri-County Municipal Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $177
Cash Discount Price: $109
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Carnegie Tri-County Municipal Hospital is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.31x the Medicare baseline. Located in 102 North Broadway, Carnegie, OK.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$177

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: $109 (80%)

Insurance Median: $177 (131%)

Cash: $109 (80% of Medicare)

Ins. Median: $177 (131% 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.

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
Aetna	$82 - $255	60%
UnitedHealthcare	$82 - $242	60%
Blue Cross Blue Shield	$84 - $217	62%
Ambetter / Centene	$94 - $176	69%
Health Choice - All Plans	$97 - $177	72%
Global Health Mcr Adv	$135	100%
Humana	$135 - $255	100%
Wellcare Mcr Adv - All Plans	$135	100%
Preferred Comm Ppo - All Plans	$193 - $204	142%
Community Care Comm Ip/Op Only - All Plans	$204	150%
First Health - All Plans	$217 - $230	160%
Global Health Ip/Op Only - All Other Plans	$217	160%
Multiplan - All Plans	$222 - $235	164%
Soonerselect Mcaid - All Plans	$242 - $255	178%

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 $109.
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 Carnegie Tri-County Municipal Hospital 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.