CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Baptist Memorial Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $276
Cash Discount Price: $97
vs. Medicare Baseline: 2.04x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Baptist Memorial Hospital is $276. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 2.04x the Medicare baseline. Located in 6019 Walnut Grove Road, Memphis, TN.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$276

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: $97 (72%)

Insurance Median: $276 (204%)

Cash: $97 (72% of Medicare)

Ins. Median: $276 (204% 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 204% of the Medicare baseline (a markup of 104%). 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 Cross Blue Shield	$19 - $733	14%
Magnolia Tn	$78 - $243	58%
Aetna	$79 - $318	58%
Oscar	$136 - $428	100%
Ppo Holdings	$148 - $464	109%
Cooper Realty	$156 - $489	115%
Magnolia Regional Health Center	$156 - $489	115%
Multiplan	$168 - $916	124%
Littler	$195 - $611	144%
Molina	$195 - $611	144%
Ppo Plus	$195 - $978	144%
Mpcn	$203 - $635	150%
First Choice Health Plan Of Ms	$207 - $648	153%
Humana	$211 - $660	156%
Novasys	$226 - $709	167%
Access Health Services	$234 - $733	173%
Butler Snow	$234 - $733	173%
UnitedHealthcare	$234 - $733	173%
Qca	$292 - $916	215%
Christian Health Aid	$312 - $978	230%
St. Jude Children'S Hospital	$351 - $1,100	259%

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 $97.
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 Baptist Memorial Hospital 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.