CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Trident Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $441
Cash Discount Price: $1,057
vs. Medicare Baseline: 3.25x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Trident Medical Center is $441. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,057. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 3.25x the Medicare baseline. Located in 9330 Medical Plaza Dr, Charleston, SC.

Cash / Self-Pay

$1,057

Average discount available for prompt cash payment at this facility.

Insurance Median

$441

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: $1,057 (779%)

Insurance Median: $441 (325%)

Cash: $1,057 (779% of Medicare)

Ins. Median: $441 (325% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 325% of the Medicare baseline (a markup of 225%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 Health Plan	$75	55%
Blue Cross Blue Shield	$75 - $1,290	55%
Absolute Total Care	$81 - $244	60%
Aetna	$83 - $642	61%
Nhc Advantage	$105 - $258	77%
Pruitt Health	$105 - $258	77%
Sc State Employees	$146	108%
Medcost	$211 - $763	156%
United	$221 - $611	163%
Select Health	$238 - $584	176%
Employers Health Network	$249 - $611	184%
Occunet	$276 - $679	204%
Vocational Rehab	$299 - $733	221%
Humana	$359 - $1,018	265%
First Health	$404 - $991	298%
Mhnet	$415 - $1,018	306%
Evernorth	$442 - $1,086	326%
Multiplan	$470 - $1,154	347%
Prime Health	$470 - $1,154	347%
Novanet	$498 - $1,222	367%
United Behavioral Health	$553 - $1,358	408%

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 $1,057.
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 Trident 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.