CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Bear River Valley Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $578
Cash Discount Price: $456
vs. Medicare Baseline: 4.26x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Bear River Valley Hospital is $578. 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 4.26x the Medicare baseline. Located in 905 North 1000 West, Tremonton, UT.

Cash / Self-Pay

$456

Average discount available for prompt cash payment at this facility.

Insurance Median

$578

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: $578 (426%)

Cash: $456 (336% of Medicare)

Ins. Median: $578 (426% 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 426% of the Medicare baseline (a markup of 326%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $584	70%
American Health	$95 - $123	70%
Blue Cross Blue Shield	$95 - $578	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 - $578	70%
UnitedHealthcare	$95 - $578	70%
Ut Cancer Control	$120	88%
Injury Care Of Nevada	$456	336%
Byu Risk Management	$517	381%
Corporation Of The President	$517	381%
Corvel Corporation	$517	381%
Wcf Insurance	$517	381%
Awh Connected	$578 - $584	426%
Byu Athletics	$578	426%
Campbell Scientific	$578	426%
Cigna	$578	426%
Deseret Mutual	$578	426%
Emi	$578	426%
Emi Health	$578	426%
Franklin County	$578	426%
Global Excel	$578	426%
Health Utah	$578	426%
Hygeia Corporation	$578	426%
Ifit	$578	426%
Juniper Systems	$578	426%
Lw Miller	$578	426%
Managed Care Admin	$578	426%
Medcare International	$578	426%
Motivhealth	$578	426%
Pehp	$578	426%
Prodegi Corp Benefit	$578	426%
Springtide	$578	426%
Tanner Llc	$578	426%
Uofu	$578	426%
Utah Tech	$578	426%
Wise Network	$578	426%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $456.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Bear River Valley Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.