CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: OHSU Hospital and Clinics

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $239
  • Cash Discount Price: $247
  • vs. Medicare Baseline: 1.76x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at OHSU Hospital and Clinics is $239. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.76x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.
Cash / Self-Pay
$247

Average discount available for prompt cash payment at this facility.

Insurance Median
$239

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: $247 (182%)
Insurance Median: $239 (176%)
Cash: $247 (182% of Medicare)
Ins. Median: $239 (176% 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
Community Health Plan Of Washington $28 - $223 21%
Kaiser Foundation Hospitals $70 - $697 52%
Moda $72 - $716 53%
Samaritan Health Plan $80 - $639 59%
Blue Cross Blue Shield $87 - $271 64%
Care Oregon $87 - $697 64%
Pacific Source $88 - $904 65%
Tuality Health $94 - $755 69%
Coventry First Health $109 - $872 80%
First Choice $110 - $880 81%
Health Net Health Plan Of Oregon, Inc. $112 - $900 83%
Aetna $113 - $906 83%
Providence Health Plan $123 - $988 91%
Cigna $133 - $1,062 98%
Molina Exchange $145 - $1,162 107%
Medicare (plans) $169 125%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3181 Sw Sam Jackson Park Road, Portland, OR 97239
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals