CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Grant Regional Health Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $126
  • Cash Discount Price: $173
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Grant Regional Health Center is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.93x the Medicare baseline. Located in 507 S Monroe St, Lancaster, WI.
Cash / Self-Pay
$173

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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: $173 (128%)
Insurance Median: $126 (93%)
Cash: $173 (128% of Medicare)
Ins. Median: $126 (93% 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 - All Plans $23 - $201 17%
Dean Health Plan - All Plans $72 53%
UnitedHealthcare $93 - $236 69%
Medical Associates - All Plans $95 - $197 70%
Quartz Mcr Adv $117 86%
Wps - All Plans $121 - $215 89%
Quartz Health Solution - All Other Plans $145 - $196 107%
Blue Cross Blue Shield $153 - $225 113%
Americhoice Mcaid - All Plans $266 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 507 S Monroe St, Lancaster, WI 53813
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals