CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Johnson County Community Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $58
  • Cash Discount Price: $41
  • vs. Medicare Baseline: 0.43x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Johnson County Community Hospital is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.43x the Medicare baseline. Located in 1901 S Shady St, Mountain City, TN.
Cash / Self-Pay
$41

Average discount available for prompt cash payment at this facility.

Insurance Median
$58

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: $41 (30%)
Insurance Median: $58 (43%)
Cash: $41 (30% of Medicare)
Ins. Median: $58 (43% 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
Aetna $51 - $113 38%
Amerigroup $51 38%
Managed Medicaire $51 38%
Medicare (plans) $51 38%
Sentara Health $51 - $60 38%
United Mine Workers Of America $51 38%
UnitedHealthcare $51 - $86 38%
Wellcare $51 38%
Humana $52 38%
Blue Cross Blue Shield $53 - $133 39%
Molina Healthcare $53 39%
Cigna $54 - $84 40%
Devoted Health Plan $54 40%
Nhc Advantage $54 40%
Ambetter / Centene $57 42%
Medcost $62 46%
First Health Coventry $133 98%
Seven Corners, Inc. $177 131%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 S Shady St, Mountain City, TN 37683
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals