CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Geisinger Wyoming Valley Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $185
Cash Discount Price: $246
vs. Medicare Baseline: 1.36x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Geisinger Wyoming Valley Medical Center is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $246. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.36x the Medicare baseline. Located in 1000 East Mountain Boulevard, Wilkes Barre, PA.

Cash / Self-Pay

$246

Average discount available for prompt cash payment at this facility.

Insurance Median

$185

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: $246 (181%)

Insurance Median: $185 (136%)

Cash: $246 (181% of Medicare)

Ins. Median: $185 (136% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicaid / KanCare	$54	40%
Geisinger Family Plan	$56	41%
Amerihealth	$63	46%
Blue Cross Blue Shield	$64 - $92	47%
Upmc For You	$64	47%
Health Partners	$65	48%
Upmc Chip	$68	50%
Cigna	$172 - $180	127%
Aetna	$185 - $265	136%
Christian Healthcare Ministries	$198	146%
Wyoming Seminary	$278	205%
Intergroup Services	$337	249%
Multiplan	$337	249%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $246.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Geisinger Wyoming Valley Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.