CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Samaritan Albany General Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $168
  • Cash Discount Price: $224
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Samaritan Albany General Hospital is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $224. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.24x the Medicare baseline. Located in 1046 6Th Avenue Sw, Albany, OR.
Cash / Self-Pay
$224

Average discount available for prompt cash payment at this facility.

Insurance Median
$168

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: $224 (165%)
Insurance Median: $168 (124%)
Cash: $224 (165% of Medicare)
Ins. Median: $168 (124% 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
Pacificsource $82 - $279 60%
Moda $84 - $280 62%
Providence $84 - $320 62%
Devoted Health $92 - $141 68%
Healthnet $92 - $320 68%
Humana $92 - $322 68%
Samaritan $92 - $296 68%
Cigna $94 - $314 69%
Regence $104 - $398 77%
Ihn $124 - $138 91%
Aetna $140 - $314 103%
First Choice $140 - $286 103%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1046 6Th Avenue Sw, Albany, OR 97321
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals