CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $157
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Independence Health System Butler Memorial Hospita is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.16x the Medicare baseline. Located in One Hospital Way, Butler, PA.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$157

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: $193 (142%)
Insurance Median: $157 (116%)
Cash: $193 (142% of Medicare)
Ins. Median: $157 (116% 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
Upmc $33 - $289 24%
Highmark $44 - $51 32%
Highmark - Ind.& Managed Care $44 - $51 32%
Highmark Aca - Direct Blue $44 - $51 32%
Highmark Community Blue $44 - $51 32%
Pnoa $65 - $220 48%
Ellwood Group $70 - $118 52%
Martin'S Point - Usfhp $82 - $96 60%
Devoted Health Plan $93 - $110 69%
Aetna $116 - $220 86%
Ccbh - Behavioral Health $116 - $138 86%
Cigna $116 - $138 86%
Workers Comp $127 94%
Behavioral $145 107%
Peak Health $163 - $192 120%
Private Healthcare Systems $163 - $234 120%
Devon $175 - $206 129%
Intergroup $186 - $220 137%
Multiplan $210 - $248 155%
Geisinger $233 - $275 172%
Gateway $245 - $289 181%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Way, Butler, PA 16001
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals