CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Physicians Regional Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $142
Cash Discount Price: $2,043
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Physicians Regional Medical Center is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,043. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.05x the Medicare baseline. Located in 7565 Dannaher Way Powell, Powell, TN.

Cash / Self-Pay

$2,043

Average discount available for prompt cash payment at this facility.

Insurance Median

$142

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: $2,043 (1507%)

Insurance Median: $142 (105%)

Cash: $2,043 (1507% of Medicare)

Ins. Median: $142 (105% 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	$63 - $1,821	46%
Veterans Eval Services	$117	86%
Node Us Dept Of Labor	$142	105%
Self Pay	$2,043	1507%
Multiplan	$5,069 - $6,665	3738%

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 $2,043.
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 Physicians Regional Medical Center 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.