CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Charleston Area Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $129
  • Cash Discount Price: $239
  • vs. Medicare Baseline: 0.95x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Charleston Area Medical Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $239. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.95x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.
Cash / Self-Pay
$239

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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: $239 (176%)
Insurance Median: $129 (95%)
Cash: $239 (176% of Medicare)
Ins. Median: $129 (95% 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
Triwest Va $50 - $125 37%
Blue Cross Blue Shield $52 - $286 38%
Choicecare Network $52 - $220 38%
UnitedHealthcare $53 - $308 39%
The Health Plan Of West Virginia Inc. $54 - $217 40%
West Virginia Senior Advantage Inc. $54 - $135 40%
Aetna $58 - $220 43%
Unicare Health Plan Of West Virginia Inc. $60 - $79 44%
Optimum Choice Inc. $82 - $129 60%
Integrated Medical Solutions $100 - $187 74%
City Of Charleston $102 - $168 75%
Naphcare $103 - $177 76%
Caresource $118 - $193 87%
Breast & Cervical Cancer Screening Program $124 91%
Tricare $124 - $188 91%
Cigna $192 - $311 142%
Three Rivers Providers Network $200 - $305 147%
Healthsmart $202 - $308 149%
Multiplan $202 - $308 149%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Morris Street, Charleston, WV 25301
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals