Office visit, established patient (30-39 min)
Facility: Greeley County Health Services
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $230
- Cash Discount Price: $132
- vs. Medicare Baseline: 1.70x 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 |
|---|---|---|
| Blue Cross Blue Shield | $105 | 77% |
| Veterans Affairs Community Care Network | $230 | 170% |
| Medicare (plans) | $230 | 170% |
Consumer Guidance & Cost Commentary
For this office visit with an established patient lasting 30 to 39 minutes, Greeley County Health Services in Tribune, KS, lists a gross charge of $189.00. While the facility's cash median price is $132.00, the negotiated rates for in-network insurance are significantly higher, with Blue Cross Blue Shield and the Veterans Affairs Community Care Network both set at $230.00, and Medicare at $135.60. This data indicates that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $132.00 upfront could result in lower total costs compared to the insurance negotiated rate of $230.00. It is important to note that hospitals often offer prompt-pay discounts of 20% to 50% for upfront payment, which could further reduce the final bill below the listed cash median.
Patients should be aware that the $189.00 gross charge represents the maximum list price before any discounts or insurance adjustments, and it is not the amount you will likely pay. Since this is a Critical Access Hospital with government local ownership, you may be eligible for additional self-pay or prompt-pay reductions if you request them before scheduling or check-in. If you choose to use insurance, be prepared for the possibility of balance billing if you are out-of-network, though the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. Always verify your specific plan's deductible status and ask the billing department for a detailed itemized statement to ensure no errors exist before finalizing payment.