CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Sanford Medical Center Aberdeen

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $207
  • Cash Discount Price: $234
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Sanford Medical Center Aberdeen is $207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.53x the Medicare baseline. Located in 2905 3Rd Ave Se, Aberdeen, SD.
Cash / Self-Pay
$234

Average discount available for prompt cash payment at this facility.

Insurance Median
$207

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: $234 (173%)
Insurance Median: $207 (153%)
Cash: $234 (173% of Medicare)
Ins. Median: $207 (153% 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
Sanford Health Plan Align $116 86%
Ucare $125 - $229 92%
Aetna $126 - $240 93%
Blue Cross Blue Shield $126 93%
Health Partners $126 - $185 93%
Medicare (plans) $126 93%
UnitedHealthcare $126 - $245 93%
Primewest $128 94%
Sanford Health Plan $130 - $174 96%
Security Health Plan $161 119%
Medica $252 - $269 186%
First Choice Health Network $264 195%
Healthez $264 195%
Multiplan $264 195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2905 3Rd Ave Se, Aberdeen, SD 57402
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals