CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Marshfield Medical Center - Weston

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $117
Cash Discount Price: $143
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Marshfield Medical Center - Weston is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.86x the Medicare baseline. Located in 3400 Ministry Parkway, Weston, WI.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $143 (105%)

Insurance Median: $117 (86%)

Cash: $143 (105% of Medicare)

Ins. Median: $117 (86% 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.

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
Family Health Center (Fhc)	$50 - $100	37%
Amish/Mennonite	$55 - $110	41%
Sanford Health Plan	$55 - $110	41%
The Alliance	$77 - $295	57%
Group Health Cooperative Of Eau Claire	$82 - $180	60%
UnitedHealthcare	$83 - $165	61%
Besse Forest Products	$85 - $170	63%
Molina Healthcare Of Wi	$85 - $170	63%
Rice Lake School District	$85 - $170	63%
Wps Health Insurance	$88 - $193	65%
Medica Of Wi	$93 - $190	69%
Cigna	$94 - $188	69%
Healtheos By Multiplan Inc.	$94 - $190	69%
Corvel	$95 - $190	70%
First Health	$95 - $190	70%
Health Partners	$95 - $190	70%
Three Rivers Provider Network (Trpn)	$95 - $190	70%
Coventry	$96 - $192	71%
Health Smart	$96 - $192	71%
Trilogy	$96 - $192	71%
Rising Medical Work Comp	$97 - $194	72%
Security Health Plan (Shp)	$106 - $146	78%
Blue Cross Blue Shield	$312 - $446	230%

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 $143.
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 Marshfield Medical Center - Weston 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.