CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Aurora Medical Center - Summit

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $207
  • Cash Discount Price: $259
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Aurora Medical Center - Summit is $207. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $259. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.53x the Medicare baseline. Located in 36500 Aurora Drive, Summit, WI.
Cash / Self-Pay
$259

Average discount available for prompt cash payment at this facility.

Insurance Median
$207

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: $259 (191%)
Insurance Median: $207 (153%)
Cash: $259 (191% of Medicare)
Ins. Median: $207 (153% 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
Common Ground $65 48%
Blue Cross Blue Shield $66 - $586 49%
Quartz One $70 52%
Healthpartners $74 - $518 55%
Molina Exchange $74 55%
Everpointe Elite $75 55%
Centivo $76 56%
Aetna $78 - $570 58%
Aurora Caregiver $80 59%
Quartz Group $80 59%
UnitedHealthcare $82 - $581 60%
Hs Technology $90 66%
Wisconsin Physician Service $90 - $95 66%
Cigna $100 - $584 74%
Health Payment Systems $115 85%
Trilogy $116 86%
Health Eos Plus $207 - $414 153%
Health Eos $276 - $552 204%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 36500 Aurora Drive, Summit, WI 53066
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals