CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Prisma Health Laurens County Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $135
  • Cash Discount Price: $124
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Prisma Health Laurens County Hospital is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.00x the Medicare baseline. Located in 22725 Highway 76 East, Clinton, SC.
Cash / Self-Pay
$124

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $124 (91%)
Insurance Median: $135 (100%)
Cash: $124 (91% of Medicare)
Ins. Median: $135 (100% 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
Medicaid / KanCare $16 - $164 12%
UnitedHealthcare $16 - $140 12%
Blue Cross Blue Shield $20 - $146 15%
Bluechoice [810] $23 - $63 17%
Prisma Health Seniorcare Pace - Midlands [5400] $24 - $64 18%
Prisma Health Seniorcare Pace-Upstate [5200] $24 - $64 18%
Promise Health Plan Contracted [2401] $36 - $167 27%
Orangeburg Senior Helping Center Pace [5401] $41 - $111 30%
Bob Jones Univ-Pai [821] $62 - $167 46%
Aetna $66 - $220 49%
Meritain Health Contracted [2200] $66 - $220 49%
Preferred Administrators Contracted [2839] $72 - $195 53%
Medcost [2940] $76 - $231 56%
Atlantic Packaging Contracted [4833] $77 - $208 57%
Aps Healthcare System [2981] $82 - $222 60%
Tricare $89 - $120 66%
Multiplan/Phcs Contracted [2950] $92 - $247 68%
Vsp Vision Care [2986] $93 - $250 69%
First Health Contracted [2952] $96 - $259 71%
Furman Int/Allen University Student [2951] $96 - $259 71%
Quiktrip-First Health [3067] $96 - $259 71%
Champva [3049] $130 96%
Cigna $130 - $142 96%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $130 - $135 96%
Deseret Mutual Ins Co [3066] $130 96%
Generic Skilled Nursing [3196] $130 96%
Hospice Contracted [1500] $130 96%
Hospice Non Contracted [3190] $130 96%
Medicare (plans) $130 - $156 96%
Triwest Healthcare Alliance Vcp [902] $130 - $135 96%
Va Community Care Network-Vaccn [903] $130 - $135 96%
Veterans Administration [3194] $130 - $135 96%
Humana $132 - $167 97%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $136 - $142 100%
Healthy Conn Prime-First Choice Vip Care [5300] $138 - $143 102%
Healthy Conn Prime-Molina Healthcare [5330] $143 - $149 105%
Sc Dept Of Corrections [2998] $146 108%
Scdc-Sc Dept Of Corrections [7232] $146 108%
First Choice Benefits Mgmt [3074] $156 115%
Workers Comp [600] $182 - $189 134%
Ambetter / Centene $239 - $249 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 22725 Highway 76 East, Clinton, SC 29325
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals