CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $204
  • Cash Discount Price: $234
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.50x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.
Cash / Self-Pay
$234

Average discount available for prompt cash payment at this facility.

Insurance Median
$204

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: $234 (173%)
Insurance Median: $204 (150%)
Cash: $234 (173% of Medicare)
Ins. Median: $204 (150% 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
The Alliance $51 - $199 38%
Security Health Plan (Shp) $52 - $226 38%
Amish/Mennonite $55 - $216 41%
Quartz $57 - $223 42%
Wps Health Insurance $67 - $264 49%
Cigna $68 - $290 50%
Health Payment Systems $70 - $273 52%
UnitedHealthcare $75 - $280 55%
Humana $79 - $349 58%
Group Health Cooperative Of Eau Claire $82 - $372 60%
Network Health Plan $84 - $327 62%
First Health $85 - $333 63%
Molina Healthcare Of Wi $85 - $333 63%
Trilogy $90 - $353 66%
Healtheos By Multiplan Inc. $93 - $372 69%
Health Partners $95 - $372 70%
Coventry $96 - $376 71%
Blue Cross Blue Shield $530 - $796 391%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 707 S University Ave, Beaver Dam, WI 53916
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals