CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: UPMC Wellsboro

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $75
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 0.55x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at UPMC Wellsboro is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.55x the Medicare baseline. Located in 32-36 Central Avenue, Wellsboro, PA.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $102 (75%)
Insurance Median: $75 (55%)
Cash: $102 (75% of Medicare)
Ins. Median: $75 (55% 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
Aetna $14 - $470 10%
Blue Cross Blue Shield $16 - $276 12%
Highmark Wholecare (Prev Gateway) $16 - $109 12%
Upmc Health Plan $16 - $238 12%
Cigna $17 - $114 13%
Pa Health & Wellness $17 - $118 13%
UnitedHealthcare $17 - $463 13%
Wirerope Works $44 - $303 32%
Geisinger $53 - $365 39%
Amerihealth Caritas $60 44%
Multiplan $62 - $518 46%
America'S Choice $71 - $490 52%
Intergroup $71 - $490 52%
Health Partners Plans (Jefferson Health Plan) $82 60%
Upmc Work Partners $122 90%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 32-36 Central Avenue, Wellsboro, PA 16901
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals