Office visit, established patient (30-39 min)
Facility: Lewisgale Medical Center
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $525
- Cash Discount Price: $656
- vs. Medicare Baseline: 3.87x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 387% of the Medicare baseline (a markup of 287%). 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.
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 | $98 - $470 | 72% |
| Lifeworks | $125 - $168 | 92% |
| Universal Healthcare Group | $144 - $195 | 106% |
| Virginia Health Network | $230 - $629 | 170% |
| United | $239 - $399 | 176% |
| Naphcare | $328 - $443 | 242% |
| Greenvbrier Sporting Club | $394 - $532 | 291% |
| Graham-White Manufacturing | $459 - $620 | 338% |
| Richfield Nursing Center | $459 - $620 | 338% |
| Corvel | $472 - $638 | 348% |
| Community Care Network | $492 - $664 | 363% |
| Richfield Retirement Community | $492 - $664 | 363% |
| Csx Hotels | $525 - $709 | 387% |
| Occunet Workers Comp | $525 - $709 | 387% |
| One Health Plan | $525 - $709 | 387% |
| Patients Choice | $577 - $780 | 426% |
| 4Most | $590 - $797 | 435% |
| Alleghany Highland Community | $590 - $797 | 435% |
| American Postal Workers Union | $590 - $797 | 435% |
| C&O Employees Hospital Assn | $590 - $797 | 435% |
| Multiplan | $590 - $797 | 435% |
| Phcs | $590 - $797 | 435% |
| Star Transportation | $590 - $797 | 435% |
| United Behavioral Health | $656 - $886 | 484% |