CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Arbor Health Morton Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $125
  • Cash Discount Price: $168
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Arbor Health Morton Hospital is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.92x the Medicare baseline. Located in 521 Adams Street, Morton, WA.
Cash / Self-Pay
$168

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $168 (124%)
Insurance Median: $125 (92%)
Cash: $168 (124% of Medicare)
Ins. Median: $125 (92% 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
First Choice-All Plans $51 - $252 38%
Amerigroup-All Other Plans $67 - $124 49%
Comm Health Healthy Options $67 - $117 49%
Kaiser Mcaid $67 - $117 49%
Molina Mcaid $67 - $225 49%
UnitedHealthcare $67 - $217 49%
Comm Health Basic Sub - All Other Plans $80 - $230 59%
Kaiser Comm-All Other Plans $107 - $213 79%
Comm Health Pebb $120 - $230 88%
Aetna $125 - $238 92%
Amerigroup Mcr Adv $125 92%
Comm Health Mcr Adv $125 92%
Healthnet Mcr Adv - All Plans $125 92%
Humana $125 92%
Mcr Railroad Mcr Adv - All Plans $125 92%
Medicare (plans) $125 92%
Premera Hmo Mcr Adv $125 92%
Rural Health Mcare - All Plans $125 92%
Regence Blue Shield Mcr Adv $126 93%
Molina Mcr Adv $131 - $136 97%
Wellcare Mcr Adv - All Plans $131 97%
Molina Marketplace-All Other Plans $160 - $163 118%
Regence Blue Shield Ump-All Other Plans $190 140%
Premera First-All Other Plans $244 180%
Cigna $252 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 521 Adams Street, Morton, WA 98356
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals