CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: St Charles Medical Center Prineville

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$222

about 1.6× the $136 Medicare rate · typically $143–$372

modeled estimate · not a bill or quote

What this hospital charges insurers

$150

Below the fair price — a good deal

about $72 under the fair price · 1.1× Medicare

Medicare pays $136 Fair price $222 This hospital $150 Cash price $493 Hospital's list price $616

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

Highest price of the 9 OR hospitals we have prices for — worth calling around.

Cheapest $51 Priciest $150

Black dot = this hospital, among the 9 OR hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Office visit, established patient (30-39 min) is about $222 (about 1.6× the $136 Medicare rate). St Charles Medical Center Prineville charges insurers about $150, or about $493 in cash — below the fair price — a good deal. Located in Prineville, OR.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$94 - $1,549	69%
Blue Cross Blue Shieldmajor	$103 - $516	76%
Aetnamajor	$94 - $1,459	69%
Cignamajor	$94 - $469	69%
Humanamajor	$94 - $469	69%
Kaiser Permanentemajor	$94 - $1,452	69%
Devoted Health	$94 - $469	69%
Health Net	$94 - $1,576	69%
Moda Health	$317 - $1,676	234%
PacificSource	$132 - $917	97%
Providence Health Plan	$235 - $1,467	173%
UniCare	$94 - $469	69%
WellCare	$94 - $469	69%
+ 60 smaller / regional plans	$94 - $1,676

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 493), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99214.

Insurance Before you use insurance

Call your insurance company to confirm St Charles Medical Center Prineville is in-network.
Ask your insurer whether prior approval is required for CPT code 99214.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at St Charles Medical Center Prineville

Compare: Office visit, established patient (30-39 min) at other OR hospitals

Insurance negotiated median for the same procedure, sorted lowest first.