CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Prisma Health Greer Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $155
Cash Discount Price: $181
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Prisma Health Greer Memorial Hospital is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.14x the Medicare baseline. Located in 1413 John B White Sr Blvd Suite D, Spartanburg, SC.

Cash / Self-Pay

$181

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $181 (133%)

Insurance Median: $155 (114%)

Cash: $181 (133% of Medicare)

Ins. Median: $155 (114% 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
Blue Choice Healthplan Of Sc	$63 - $94	46%
Prisma Health Seniorcare Pace-Upstate	$67	49%
Medicaid / KanCare	$68 - $101	50%
Bluechoice Healthplan Of Sc	$71 - $100	52%
Humana	$73 - $222	54%
Molina	$73 - $132	54%
Select Health	$73 - $129	54%
Medicare (plans)	$83	61%
Blue Cross Blue Shield	$96 - $193	71%
Aetna	$97 - $245	72%
Tricare	$122 - $222	90%
Choicecare Network	$125 - $236	92%
Value Options	$139	103%
Promise Health Plan	$167	123%
Wellpath Select Inc	$168	124%
Sc Workers Compensation	$171	126%
Preferred Care, Inc	$195	144%
Chp Direct Supermed Network	$200	147%
Medcost	$206	152%
Atlantic Packaging	$208	153%
Aps Healthcare Bethesda Inc	$222	164%
Cigna	$222	164%
Medcost Preferred	$228	168%
Multiplan	$247	182%
Companion Benefit Alternatives	$278	205%
Miscellaneous	$278	205%
Self Pay	$278	205%

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 $181.
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 Prisma Health Greer Memorial Hospital 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.