CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Pennsylvania Hospital

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$118
about 0.9× the $136 Medicare rate · typically $92–$209
modeled estimate · not a bill or quote
What this hospital charges insurers
$258
Well above the fair price
about $140 over the fair price · 1.9× Medicare
Medicare pays $136 Fair price $118 This hospital $258 Cash price $299 Hospital's list price $299

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

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

Cheapest $25 Priciest $258

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

A fair price for a Office visit, established patient (30-39 min) is about $118 (about 0.9× the $136 Medicare rate). Pennsylvania Hospital charges insurers about $258, or about $299 in cash — well above the fair price. Located in Philadelphia, PA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $118. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $53 - $341 39%
Blue Cross Blue Shieldmajor $64 - $341 47%
Aetnamajor $72 - $341 53%
Cignamajor $87 - $131 64%
Humanamajor $206 - $341 152%
Clover Health $258 - $341 190%
Geisinger $258 - $341 190%
Health Net $155 - $205 114%
HealthPartners $57 - $341 42%
Oscar Health $258 - $341 190%
UPMC Health Plan $64 - $341 47%
+ 33 smaller / regional plans $35 - $341
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.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

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

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals