CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Baptist Memorial Hospital - Carroll County

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $312
  • Cash Discount Price: $124
  • vs. Medicare Baseline: 2.30x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Baptist Memorial Hospital - Carroll County is $312. 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 2.30x the Medicare baseline. Located in 631 Rb Wilson Dr, Huntingdon, TN.
Cash / Self-Pay
$124

Average discount available for prompt cash payment at this facility.

Insurance Median
$312

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: $312 (230%)
Cash: $124 (91% of Medicare)
Ins. Median: $312 (230% 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 230% of the Medicare baseline (a markup of 130%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $49 - $325 36%
Aetna $79 - $338 58%
Magnolia Tn $120 88%
Ppo Holdings $206 152%
Magnolia Regional Health Center $216 159%
Cigna $234 173%
Littler $270 199%
UnitedHealthcare $312 230%
Oscar $352 260%
Humana $357 263%
First Choice Health Plan Of Ms $379 279%
Mpcn $406 299%
Multiplan $406 299%
Novasys $406 299%
Ppo Plus $460 339%
Qca $487 359%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 631 Rb Wilson Dr, Huntingdon, TN 38344
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals