Office visit, established patient (30-39 min)
Facility: Lindsborg Community Hospital
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $137
- Cash Discount Price: $115
- vs. Medicare Baseline: 1.01x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $50 - $115 | 37% |
| Coventry Mcr Adv | $50 - $116 | 37% |
| Blue Cross Blue Shield | $80 | 59% |
| Cigna | $90 - $207 | 66% |
| Coventry Comm-All Other Plans | $95 - $219 | 70% |
| UnitedHealthcare | $95 - $219 | 70% |
| Multiplan-All Plans | $98 - $227 | 72% |
| Phcs Preferred-All Plans | $98 - $227 | 72% |
| Century Health-All Plans | $100 - $232 | 74% |
| Coventry Wc | $100 - $232 | 74% |
| Health Partners -All Plans | $100 - $232 | 74% |
| Wppa-All Plans | $100 - $232 | 74% |
Consumer Guidance & Cost Commentary
For this office visit at Lindsborg Community Hospital in Kansas, the cash price is $115.00, which is lower than the facility's gross charge of $165.00. While the median negotiated rate across 12 payers is $137.00, patients with high-deductible plans might find paying cash directly more cost-effective, as the cash price is below the average allowed amount for most insurers. It is important to note that commercial negotiated rates often include administrative overhead and can exceed the true cost of care; for context, fair pricing is typically defined as 120% to 150% of the Medicare rate of $135.60, whereas many commercial contracts average 200% to 300% of this benchmark.
Before scheduling, patients should verify their specific plan's allowed amount, as some in-network rates can be significantly higher than others. If you choose to pay out-of-pocket, ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, if you are covered by insurance, be aware that balance billing could occur if you receive care from an out-of-network provider, though the No Surprises Act protects you from such surprise bills for emergency and non-emergency services at in-network facilities. Always request a full itemized bill before paying to ensure no errors or unbundled charges are included, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit.