CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Intermountain Health Sevier Valley Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $317
  • Cash Discount Price: $251
  • vs. Medicare Baseline: 2.34x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Intermountain Health Sevier Valley Hospital is $317. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $251. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 2.34x the Medicare baseline. Located in 1000 North Main Street, Richfield, UT.
Cash / Self-Pay
$251

Average discount available for prompt cash payment at this facility.

Insurance Median
$317

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: $251 (185%)
Insurance Median: $317 (234%)
Cash: $251 (185% of Medicare)
Ins. Median: $317 (234% 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 234% of the Medicare baseline (a markup of 134%). 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 - $321 70%
American Health $95 - $123 70%
Health Partners Of Nevada $95 - $123 70%
Health Plan Of Nevada $95 - $297 70%
Healthy U $95 - $297 70%
Humana $95 - $317 70%
Molina $95 - $317 70%
Selecthealth $95 - $317 70%
UnitedHealthcare $95 - $317 70%
Ut Cancer Control $120 88%
Injury Care Of Nevada $251 185%
Byu Risk Management $284 209%
Corporation Of The President $284 209%
Corvel Corporation $284 209%
Wcf Insurance $284 209%
Awh Connected $317 - $321 234%
Blue Cross Blue Shield $317 234%
Byu Athletics $317 234%
Campbell Scientific $317 234%
Cigna $317 234%
Deseret Mutual $317 234%
Emi $317 234%
Emi Health $317 234%
Franklin County $317 234%
Global Excel $317 234%
Health Utah $317 234%
Hygeia Corporation $317 234%
Ifit $317 234%
Juniper Systems $317 234%
Lw Miller $317 234%
Managed Care Admin $317 234%
Medcare International $317 234%
Motivhealth $317 234%
Pehp $317 234%
Prodegi Corp Benefit $317 234%
Springtide $317 234%
Tanner Llc $317 234%
Uofu $317 234%
Utah Tech $317 234%
Wise Network $317 234%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 North Main Street, Richfield, UT 84701
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals