CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Methodist Medical Center of Oak Ridge

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $124
Cash Discount Price: $64
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Methodist Medical Center of Oak Ridge is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.91x the Medicare baseline. Located in 990 Oak Ridge Turnpike Box 529, Oak Ridge, TN.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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: $64 (47%)

Insurance Median: $124 (91%)

Cash: $64 (47% of Medicare)

Ins. Median: $124 (91% 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.

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 Cross Blue Shield	$26 - $150	19%
Aetna	$49 - $100	36%
Ehn	$55 - $112	41%
UnitedHealthcare	$61 - $237	45%
Cigna	$62 - $172	46%
Ambetter / Centene	$73 - $150	54%
Correctional Medical Services	$73 - $150	54%
Community Services Network	$79 - $162	58%
Usa Managed Care Organization	$85 - $175	63%
Novanet	$92 - $188	68%
Direct Care America	$98 - $200	72%
Medsave Usa	$98 - $200	72%
National Provider Network	$98 - $200	72%
Beech Street	$104 - $212	77%
Ccn Managed Care	$104 - $212	77%
Initial Group	$107 - $220	79%
Galaxy Health Network	$110 - $225	81%

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 $64.
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 Methodist Medical Center of Oak Ridge 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.