CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: St Mary Medical Center

Billing Code: 99214 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$59
about 0.4× the $136 Medicare rate · typically $53–$150
modeled estimate · not a bill or quote
What this hospital charges insurers
$54
About the fair price
about $5 under the fair price · 0.4× Medicare
Medicare pays $136 Fair price $59 This hospital $54 Hospital's list price $207

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

One of the lower prices — 6 of 8 other PA hospitals charge more for the same procedure.

Cheapest $25 Priciest $64

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 $59 (about 0.4× the $136 Medicare rate). St Mary Medical Center charges insurers about $54 — about the fair price. Located in Langhorne, PA.

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 $14 - $117 10%
Blue Cross Blue Shieldmajor $14 - $236 10%
Aetnamajor $14 - $191 10%
Cignamajor $14 - $231 10%
Humanamajor $14 - $252 10%
Kaiser Permanentemajor $17 - $109 13%
Ambetter (Centene) $20 - $409 15%
AmeriHealth $17 - $109 13%
Clover Health $14 - $117 10%
GEHA $14 - $104 10%
Health Net $16 - $159 12%
HealthPartners $19 - $159 14%
Meridian $14 - $117 10%
Molina $54 40%
Oscar Health $21 - $413 15%
Paramount $54 40%
Presbyterian $14 - $117 10%
Tufts Health Plan $54 40%
UPMC Health Plan $72 53%
WellMed $14 - $117 10%
WellSense $54 40%
+ 338 smaller / regional plans $14 - $269
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 16 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals