CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Medina Regional Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $97
  • Cash Discount Price: $176
  • vs. Medicare Baseline: 0.72x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Medina Regional Hospital is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.72x the Medicare baseline. Located in 3100 Avenue E, Hondo, TX.
Cash / Self-Pay
$176

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $176 (130%)
Insurance Median: $97 (72%)
Cash: $176 (130% of Medicare)
Ins. Median: $97 (72% 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
Superior Health Plan $34 - $97 25%
UnitedHealthcare $34 - $188 25%
Community First Health Plan $42 - $250 31%
Amerivantage $46 - $82 34%
Aetna $49 - $150 36%
Cigna $56 - $100 41%
Blue Advantage $70 - $125 52%
Curative $84 - $150 62%
Benefit Administrators $140 - $250 103%
Blue Cross Blue Shield $414 305%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Avenue E, Hondo, TX 78861
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals