CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Penn Presbyterian Medical Center
Billing Code: 99214 (CPT)
The BaseRate · fair price high confidence
A fair price for this
$110
about 0.8× the $136 Medicare rate · typically $92–$201
modeled estimate · not a bill or quote
Medicare pays $136 Fair price $110 Cash price $965 Hospital's list price $965
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
5 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 | $107 - $965 | 79% |
| Blue Cross Blue Shieldmajor | $241 - $965 | 178% |
| Aetnamajor | $268 - $965 | 198% |
| Cignamajor | $306 - $371 | 226% |
| Humanamajor | $772 | 569% |
| Clover Health | $965 | 712% |
| Geisinger | $965 | 712% |
| Health Net | $579 | 427% |
| HealthPartners | $57 - $965 | 42% |
| Oscar Health | $965 | 712% |
| UPMC Health Plan | $241 - $965 | 178% |
| + 33 smaller / regional plans | $70 - $965 |
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Penn Presbyterian Medical Center
Compare: Office visit, established patient (30-39 min) at other PA hospitals
- Penn State Health St. Joseph · Reading $25
- St Mary Medical Center · Langhorne $54
- Surgical Institute of Reading · Wyomissing $54
- UPMC Altoona · Altoona $57
- Lower Bucks Hospital · Bristol $58
- Roxborough Memorial Hospital · Philadelphia $58
- UPMC Wellsboro · Wellsboro $61
- St Clair Hospital · Pittsburgh $63
Insurance negotiated median for the same procedure, sorted lowest first.