CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Fort Loudoun Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $125
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Fort Loudoun Medical Center is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.92x the Medicare baseline. Located in 550 Fort Loudon Medical Center Dr, Lenoir City, TN.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $66 (49%)
Insurance Median: $125 (92%)
Cash: $66 (49% of Medicare)
Ins. Median: $125 (92% 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
Blue Cross Blue Shield $26 - $155 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

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 550 Fort Loudon Medical Center Dr, Lenoir City, TN 37772
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals