CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Lewisgale Hospital Pulaski

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $518
Cash Discount Price: $697
vs. Medicare Baseline: 3.82x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Lewisgale Hospital Pulaski is $518. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $697. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 3.82x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.

Cash / Self-Pay

$697

Average discount available for prompt cash payment at this facility.

Insurance Median

$518

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: $697 (514%)

Insurance Median: $518 (382%)

Cash: $697 (514% of Medicare)

Ins. Median: $518 (382% 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 382% of the Medicare baseline (a markup of 282%). 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	$104 - $316	77%
Lifeworks	$131 - $134	97%
Universal Healthcare Group	$152 - $155	112%
United	$231 - $316	170%
Virginia Health Network	$242 - $499	178%
Greenvbrier Sporting Club	$415 - $422	306%
Corvel	$498 - $506	367%
Richfield Nursing Center	$518 - $527	382%
Richfield Retirement Community	$518 - $527	382%
Multiplan	$532 - $541	392%
Community Care Network	$553 - $562	408%
Graham-White Manufacturing	$553 - $562	408%
Occunet Workers Comp	$553 - $562	408%
One Health Plan	$553 - $562	408%
Patients Choice	$608 - $619	448%
4Most	$622 - $633	459%
American Postal Workers Union	$622 - $633	459%
Phcs	$622 - $633	459%
Star Transportation	$622 - $633	459%

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 $697.
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 Lewisgale Hospital Pulaski 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.