CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Crossing Rivers Health Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $293
  • Cash Discount Price: $302
  • vs. Medicare Baseline: 2.16x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Crossing Rivers Health Medical Center is $293. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $302. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 2.16x the Medicare baseline. Located in 37868 Us Hwy 18, Prairie Du Chien, WI.
Cash / Self-Pay
$302

Average discount available for prompt cash payment at this facility.

Insurance Median
$293

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: $302 (223%)
Insurance Median: $293 (216%)
Cash: $302 (223% of Medicare)
Ins. Median: $293 (216% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 216% of the Medicare baseline (a markup of 116%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Humana $81 - $1,816 60%
Security Hlth Comm - All Other Plans $81 - $1,797 60%
UnitedHealthcare $81 - $795 60%
Amerigroup Mcaid-All Other Plans $86 63%
Iowa Total Care Mcaid-All Plans $86 63%
Wps - All Plans $101 - $1,835 74%
Quartz - All Plans $156 - $1,514 115%
Blue Cross Blue Shield $161 - $1,835 119%
Group Health Co-Op - All Plans $227 - $1,835 167%
Dean Health Plan - All Plans $270 - $1,797 199%
Health Trad Hp - All Plans $273 - $1,816 201%
Cigna $275 - $1,835 203%
First Health - All Plans $275 - $1,835 203%
Geha - All Plans $275 - $1,835 203%
Health Partners - All Plans $275 - $1,835 203%
Medical Associates Hp - All Plans $275 - $1,835 203%
Amerigroup Mcr Adv $795 586%
Security Hlth Mcr Adv $795 586%
Medica Comm - All Other Plans $1,797 1325%
Medica Hp Solutions $1,797 1325%
Wea Provider Ntwrk - All Plans $1,816 1339%
Preferred Health Choice - All Plans $1,835 1353%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 37868 Us Hwy 18, Prairie Du Chien, WI 53821
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals