CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Memorial Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $120
  • Cash Discount Price: $106
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Memorial Medical Center is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.88x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$106

Average discount available for prompt cash payment at this facility.

Insurance Median
$120

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: $106 (78%)
Insurance Median: $120 (88%)
Cash: $106 (78% of Medicare)
Ins. Median: $120 (88% 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
Ambetter / Centene $32 - $279 24%
Amerigroup Mcr Adv-All Other Plans $43 - $233 32%
Care Improvement Plus - All Other Plans $43 - $233 32%
Coventry First Hlth Mcr Adv $43 - $233 32%
Multiplan Mcr Adv $43 - $233 32%
Superior Allwell Mcr Adv-All Other Plans $43 - $233 32%
Triwest Va Pccc-All Plans $43 - $228 32%
UnitedHealthcare $43 - $665 32%
Universal American Mcr-All Other Plans $43 - $233 32%
Care Improvement Plus Mcr $44 - $235 32%
Universal American Snp $46 - $244 34%
Amerigroup Chip $58 - $399 43%
Amerigroup Star $58 - $399 43%
Amerigroup Star Kids $58 - $399 43%
Amerigroup Star Plus $58 - $399 43%
Comm Health Chip $58 - $399 43%
Comm Health Perinatal-All Other Plans $58 - $399 43%
Molina Chip/Star-All Plans $58 - $399 43%
Scott & White Chip/Star-All Plans $58 - $399 43%
Superior Chip/Star $58 - $399 43%
Texas Childrens Hp - All Plans $58 - $399 43%
Comm Health Mcaid Hmo $60 - $419 44%
Comm Health Star $60 - $419 44%
Healthcare Highways-All Plans $65 - $665 48%
Aetna $66 - $665 49%
Prime Healthcare Services-All Plans $70 - $582 52%
Blue Cross Blue Shield $75 - $162 55%
Humana $80 - $665 59%
Corvel Work Comp-All Plans $85 - $706 63%
Independent Med Sys Ppo-All Plans $85 - $706 63%
Multiplan Phcs Ppo-All Other Plans $85 - $706 63%
Provider Select Ppo-All Plans $85 - $706 63%
Three Rivers Ppo-All Plans $85 - $706 63%
Usa Mso - All Plans $85 - $706 63%
Capstar Health Network-All Plans $96 - $665 71%
Coventry First Hlth Hmo Ppo-All Other Plans $96 - $665 71%
Cigna $101 - $623 74%
Galaxy Health Network-All Plans $102 - $706 75%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals