CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Grand Strand Regional Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $543
Cash Discount Price: $1,071
vs. Medicare Baseline: 4.00x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Grand Strand Regional Medical Center is $543. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,071. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 4.00x the Medicare baseline. Located in 809 82Nd Parkway, Myrtle Beach, SC.

Cash / Self-Pay

$1,071

Average discount available for prompt cash payment at this facility.

Insurance Median

$543

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: $1,071 (790%)

Insurance Median: $543 (400%)

Cash: $1,071 (790% of Medicare)

Ins. Median: $543 (400% 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 400% of the Medicare baseline (a markup of 300%). 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	$72	53%
Blue Cross Blue Shield	$72 - $1,347	53%
Absolute Total Care	$106 - $255	78%
Aetna	$109 - $675	80%
Cigna	$114 - $224	84%
Nhc Advantage	$138 - $269	102%
Pruitt Health	$138 - $269	102%
Sc State Employees	$146	108%
United	$308 - $638	227%
Select Health	$311 - $610	229%
Occunet	$362 - $709	267%
Medcost	$363 - $968	268%
Vocational Rehab	$391 - $766	288%
Employers Health Network	$398 - $780	294%
Evernorth	$579 - $1,134	427%
First Health	$597 - $1,170	440%
Global Excel Management	$601 - $1,177	443%
Humana	$615 - $1,205	454%
Multiplan	$615 - $1,205	454%
National Choicecare	$615 - $1,205	454%
Prime Health	$615 - $1,205	454%
Novanet	$652 - $1,276	481%
United Behavioral Health	$724 - $1,418	534%

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 $1,071.
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 Grand Strand Regional 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.