CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mayaguez Medical Center Dr Ramon Emeterio Betances

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $73
Cash Discount Price: $100
vs. Medicare Baseline: 0.54x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mayaguez Medical Center Dr Ramon Emeterio Betances is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.54x the Medicare baseline. Located in Carr 2 Bo Sabalos, Mayaguez, PR.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $100 (74%)

Insurance Median: $73 (54%)

Cash: $100 (74% of Medicare)

Ins. Median: $73 (54% 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
Privado	$20	15%
Prossam	$20	15%
Humana	$25 - $135	18%
International Medical Card	$25	18%
Medical Card System	$25	18%
Mapfre	$30	22%
Triple S	$30 - $91	22%
Palic	$32	24%
Mmm	$66	49%
Medicare (plans)	$80	59%
Plan Vital	$80 - $130	59%
Salud Correccional	$80	59%
McS Classicare	$91	67%

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 $100.
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 Mayaguez Medical Center Dr Ramon Emeterio Betances 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.