CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Cedar City Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $547
  • Cash Discount Price: $456
  • vs. Medicare Baseline: 4.03x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Cedar City Hospital is $547. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $456. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 4.03x the Medicare baseline. Located in 1303 North Main Street, Cedar City, UT.
Cash / Self-Pay
$456

Average discount available for prompt cash payment at this facility.

Insurance Median
$547

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: $456 (336%)
Insurance Median: $547 (403%)
Cash: $456 (336% of Medicare)
Ins. Median: $547 (403% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 403% of the Medicare baseline (a markup of 303%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $95 - $585 70%
American Health $95 - $123 70%
Blue Cross Blue Shield $95 - $578 70%
Health Choice $95 - $541 70%
Health Partners Of Nevada $95 - $123 70%
Health Plan Of Nevada $95 - $541 70%
Healthy U $95 - $541 70%
Humana $95 - $123 70%
Molina $95 - $578 70%
Selecthealth $95 - $547 70%
Southwest Behavioral Health $95 - $123 70%
UnitedHealthcare $95 - $547 70%
Ut Cancer Control $120 88%
Corporation Of The President $456 336%
Corvel Corporation $456 336%
Injury Care Of Nevada $456 336%
Wcf Insurance $456 336%
Byu Risk Management $517 381%
Awh Connected $547 - $554 403%
Byu Athletic Department $547 403%
Campbell Scientific $547 403%
Deseret Mutual $547 403%
Emi $547 403%
Emi Health $547 403%
Franklin County $547 403%
Global Excel $547 403%
Ifit $547 403%
Juniper Systems $547 403%
Lw Miller $547 403%
Managed Care Admin $547 403%
Medcare International $547 403%
Motivhealth $547 403%
Pehp $547 - $578 403%
Prodegi Corp Benefit $547 403%
Tanner Llc $547 403%
Uofu $547 - $578 403%
Utah Tech $547 403%
Wise Network $547 403%
Cigna $578 426%
Health Utah $578 426%
Hygeia Corporation $578 426%
Springtide $578 426%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 North Main Street, Cedar City, UT 84721
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals