CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Intermountain Health Spanish Fork Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $131
  • Cash Discount Price: $142
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Intermountain Health Spanish Fork Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.97x the Medicare baseline. Located in 765 East Market Place Drive, Spanish Fork, UT.
Cash / Self-Pay
$142

Average discount available for prompt cash payment at this facility.

Insurance Median
$131

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: $142 (105%)
Insurance Median: $131 (97%)
Cash: $142 (105% of Medicare)
Ins. Median: $131 (97% 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 $50 - $340 37%
Donor Connect $51 38%
Health Plan Of Nevada $57 - $123 42%
Intermountain Caregiver Plan $80 - $324 59%
Aetna $95 - $160 70%
American Health $95 - $123 70%
Blue Cross Blue Shield $95 - $143 70%
Health Partners Of Nevada $95 - $123 70%
Healthy U $95 - $123 70%
Humana $95 - $123 70%
Molina $95 - $123 70%
UnitedHealthcare $95 - $160 70%
Emi $102 75%
Deseret Mutual $108 80%
Cigna $119 - $160 88%
Ut Cancer Control $120 88%
Awh Connected $121 - $123 89%
Emi Health $131 97%
Pehp $131 - $168 97%
Byu Risk Management $132 - $138 97%
Corporation Of The President $132 - $138 97%
Wcf Insurance $132 - $138 97%
Byu Athletics $136 100%
Campbell Scientific $136 100%
Corvel Corporation $136 100%
Franklin County $136 100%
Ifit $136 100%
Juniper Systems $136 100%
Lw Miller $136 100%
Tanner Llc $136 100%
Utah Tech $136 100%
Injury Care Of Nevada $142 105%
Managed Care Admin $147 108%
Prodegi Corp Benefit $155 114%
Uofu $155 114%
Springtide $157 116%
Global Excel $160 118%
Medcare International $160 118%
Motivhealth $160 118%
Wise Network $160 118%
Hygeia Corporation $170 125%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 765 East Market Place Drive, Spanish Fork, UT 84660
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals