CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Orem Community Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $232
  • Cash Discount Price: $251
  • vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Orem Community Hospital is $232. 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 1.71x the Medicare baseline. Located in 331 North 400 West, Orem, UT.
Cash / Self-Pay
$251

Average discount available for prompt cash payment at this facility.

Insurance Median
$232

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: $232 (171%)
Cash: $251 (185% of Medicare)
Ins. Median: $232 (171% 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
Selecthealth $88 - $340 65%
Donor Connect $93 69%
Aetna $95 - $284 70%
American Health $95 - $123 70%
Blue Cross Blue Shield $95 - $254 70%
Health Partners Of Nevada $95 - $123 70%
Health Plan Of Nevada $95 - $123 70%
Healthy U $95 - $123 70%
Humana $95 - $123 70%
Molina $95 - $317 70%
UnitedHealthcare $95 - $284 70%
Ut Cancer Control $120 88%
Intermountain Caregiver Plan $142 - $324 105%
Emi $180 133%
Deseret Mutual $192 142%
Cigna $210 - $284 155%
Awh Connected $212 - $215 156%
Emi Health $232 171%
Pehp $232 - $297 171%
Byu Risk Management $234 - $244 173%
Corporation Of The President $234 - $244 173%
Wcf Insurance $234 - $244 173%
Byu Athletics $240 177%
Campbell Scientific $240 177%
Corvel Corporation $240 177%
Franklin County $240 177%
Ifit $240 177%
Juniper Systems $240 177%
Lw Miller $240 177%
Tanner Llc $240 177%
Utah Tech $240 177%
Injury Care Of Nevada $251 185%
Managed Care Admin $261 192%
Prodegi Corp Benefit $274 202%
Uofu $274 202%
Springtide $277 204%
Global Excel $284 209%
Medcare International $284 209%
Motivhealth $284 209%
Wise Network $284 209%
Hygeia Corporation $301 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 331 North 400 West, Orem, UT 84057
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals