CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Childrens Hospital of the Kings Daughters Inc

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $94
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 0.69x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Childrens Hospital of the Kings Daughters Inc is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.69x the Medicare baseline. Located in 601 Children's Lane, Norfolk, VA.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $79 (58%)
Insurance Median: $94 (69%)
Cash: $79 (58% of Medicare)
Ins. Median: $94 (69% 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
Cigna $15 11%
Johns Hopkins Healthcare $22 - $428 16%
Virginia Health Network $62 - $360 46%
Blue Cross Blue Shield $63 - $273 46%
Sentara Community Plan $63 - $322 46%
UnitedHealthcare $63 - $275 46%
Medcost $75 - $382 55%
Humana $76 - $337 56%
Evernorth $79 58%
First Health $79 - $405 58%
Multiplan $81 - $414 60%
Aetna $82 - $337 60%
Sentara Health Plans $82 - $122 60%
Carolina Complete Health $84 62%
Phcs $84 - $428 62%
Vhn $84 - $428 62%
Trillium Behavioral Health $123 91%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 601 Children's Lane, Norfolk, VA 23507
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens