CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: St Francis Hospital
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $92
- Cash Discount Price: $204
- vs. Medicare Baseline: 0.68x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at St Francis Hospital is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $204. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.68x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.
Cash / Self-Pay
$204
Average discount available for prompt cash payment at this facility.
Insurance Median
$92
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: $204 (150%)
Insurance Median: $92 (68%)
Cash: $204 (150% of Medicare)
Ins. Median: $92 (68% 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 |
|---|---|---|
| Medicaid / KanCare | $62 - $98 | 46% |
| Geha | $75 | 55% |
| UnitedHealthcare | $75 - $92 | 55% |
| Blue Cross Blue Shield | $80 - $109 | 59% |
| Pace Southeast | $82 | 60% |
| Pace of Southwest Michigan | $82 - $92 | 60% |
| Michigan Complete Health | $82 | 60% |
| Eddy Senior Care-Pace | $82 | 60% |
| Sunnyview-Pace Finance Dept | $82 | 60% |
| Everence | $82 | 60% |
| Innovative Integrated Health Community Plans | $82 | 60% |
| Lifecircles Pace | $82 | 60% |
| Solis Health Plans | $82 | 60% |
| American Health Plan | $82 | 60% |
| Pace Iowa Immanuel Pathways | $82 | 60% |
| Pace Cny | $82 | 60% |
| Iowa Health Advantage | $82 | 60% |
| Hope Select Pace | $82 | 60% |
| Pace-Trinity Health | $82 | 60% |
| Martins Point Generations Advantage | $82 | 60% |
| Reliance Community Care Partners Care Resources Pace | $82 | 60% |
| Um Health Advantage | $82 | 60% |
| Gold Advantage | $82 | 60% |
| Careplus Health Plans | $82 | 60% |
| Cigna | $82 - $168 | 60% |
| Rx Grane Grnmedd | $82 | 60% |
| Hudson Headwaters Pace | $82 | 60% |
| Aurora Special Needs | $82 | 60% |
| Union Health Service | $82 | 60% |
| Ally Align Care Adv | $82 | 60% |
| Longevity Health Plan | $82 | 60% |
| Elementcare | $82 | 60% |
| Wellmed | $82 | 60% |
| Cca Senior Care Options | $82 | 60% |
| Rx Allwin | $82 | 60% |
| Eddy Seniorcare Pace | $82 | 60% |
| New Centry Health Careplus | $82 | 60% |
| Cca - Zing Health | $82 | 60% |
| Lasso Healthcare Msa | $82 | 60% |
| Peak Pace Solutions | $82 | 60% |
| Highmark Health Options Dual Plan | $82 | 60% |
| Medipak Advantage | $82 | 60% |
| Align Senior Care | $82 | 60% |
| Nascentia Health Plus | $82 | 60% |
| Todays Options | $82 | 60% |
| Mercy Life | $82 | 60% |
| Preferred Care Partners | $82 | 60% |
| The Health Plan | $82 | 60% |
| Horizon Nj Total Care | $82 | 60% |
| Humana | $82 - $92 | 60% |
| Evercare | $82 | 60% |
| Rx Retiree Rx Care | $82 | 60% |
| Life St Marys Pace | $82 | 60% |
| Huron Valley Pace | $82 | 60% |
| Central Valley Medical Services Corp Pace | $82 | 60% |
| Georgia Health Advantage | $82 | 60% |
| Johns Hopkins Advantage Md | $82 | 60% |
| Care Resources Pace | $82 | 60% |
| Community Pace at Home | $82 | 60% |
| Gpa Croell Redi Mix | $82 | 60% |
| Scan Health Plan McR IPA Meritage Oon | $82 | 60% |
| Champion Health Plan McR Advantage | $82 | 60% |
| Medicare (plans) | $82 - $93 | 60% |
| Tribute Health Plans | $82 | 60% |
| Commonwealth Care Alliance | $82 | 60% |
| Clover Health | $82 | 60% |
| Presbyterian Senior Plan | $82 | 60% |
| Siouxland Pace | $82 | 60% |
| Gateway Health Plan | $82 | 60% |
| Care Improvement Plus | $82 | 60% |
| Clear Spring Health | $82 | 60% |
| Welbe Health | $82 | 60% |
| Longevity IPA of Michigan LLC Health Plan Isnp | $82 | 60% |
| Pruitthealth Premier | $82 | 60% |
| Meridian Complete | $82 | 60% |
| American Health Advantage of Idaho | $82 | 60% |
| Thome Pace | $82 | 60% |
| Mercyone Cedar Valley | $82 | 60% |
| Genesys Pace of Genesee County | $82 | 60% |
| Provider Partners Health Plan of Illinois | $82 | 60% |
| Health America Advantra | $82 | 60% |
| Care Dimensions | $82 | 60% |
| Serenity Pace | $82 | 60% |
| Texan Plus | $82 | 60% |
| Perennial Advantage | $82 | 60% |
| Osu Prime Care Advantage | $82 | 60% |
| Blue Care Network Advantage | $82 | 60% |
| Aetna | $82 - $173 | 60% |
| Mass General Brigham McR Adv | $82 | 60% |
| Provider Partners Health Plan of Indiana | $82 | 60% |
| Secure Horizons Ma Pffs | $82 | 60% |
| Veterans Administration | $84 | 62% |
| Blue Shield - De (Highmark) Medciare Advantage | $87 | 64% |
| Champva | $90 | 66% |
| Tricare | $90 | 66% |
| Veterans Eval Services | $90 | 66% |
| Triwest Health Alliance | $90 | 66% |
| Us Family Health Plan | $90 | 66% |
| Robert F Sing Program | $92 | 68% |
| Connections Csp | $92 | 68% |
| Delta Dental Nj | $92 | 68% |
| Cmh Genesee County | $92 | 68% |
| Wellsense Health Plan | $92 | 68% |
| Cmh Misc | $92 | 68% |
| Cmh Macomb | $92 | 68% |
| Rx Medi-Cal | $92 | 68% |
| Community Care Behavorial Health | $92 | 68% |
| Care Oregon Ohp | $92 | 68% |
| Eastpointe Lme | $92 | 68% |
| Care Connections of Northern Iowa | $92 | 68% |
| Cmh Northern Lakes County | $92 | 68% |
| Jai Medical System | $92 | 68% |
| California Health and Wellness | $92 | 68% |
| Cencal Health Plan | $92 | 68% |
| Kern Family Health Plan | $92 | 68% |
| Cmh Jackson County/Lifeways | $92 | 68% |
| Medstar Md Health Choice | $92 | 68% |
| Freedom First Healthcare | $92 | 68% |
| Molina Centennial Care | $92 | 68% |
| Medi-Cal | $92 | 68% |
| Hennepin Health | $92 | 68% |
| Indiana Breast Cervical Cancer | $92 | 68% |
| Cmh Ottawa County | $92 | 68% |
| Broward County Dept of Health | $92 | 68% |
| Covid19 Hrsa Uninsured Testing and Treatment Fund | $92 | 68% |
| Nextlevel Health | $92 | 68% |
| Rx Meridian Rx | $92 | 68% |
| Medstar Dc Healthy Family | $92 | 68% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $92 | 68% |
| Massachusetts Behavioral Health Partnership | $92 | 68% |
| Cmh Barry County | $92 | 68% |
| Bcccp-Michigan | $92 | 68% |
| Parkland Community Health Plan | $92 | 68% |
| Cmh Wayne County/Carelink | $92 | 68% |
| Maryland Healthy Smiles - Scion Dental | $92 | 68% |
| Fresno County Ccs | $92 | 68% |
| New York Cancer Services Program | $92 | 68% |
| Bmc Healthnet | $92 | 68% |
| Ryan White Florida Mssrp | $92 | 68% |
| Cmh Ausable Valley | $92 | 68% |
| Nascentia Health Options | $92 | 68% |
| Maryland Physicians Care | $92 | 68% |
| Paramount Advantage | $92 | 68% |
| Community Health Choice | $92 | 68% |
| Idaho Dept Health and Wellfare | $92 | 68% |
| Community Care Partners | $92 | 68% |
| County Funding Generic | $92 | 68% |
| Childrens Comm Health Plan | $92 | 68% |
| Medi-Cal Healthnet | $92 | 68% |
| Dph Tb Program | $92 | 68% |
| Childrens Medical Services Title 19 | $92 | 68% |
| Sandhills Center Lme | $92 | 68% |
| Inland Empire Health Plan | $92 | 68% |
| Ghc Scw Wi Badgercare | $92 | 68% |
| Vaya Health Lme | $92 | 68% |
| Community Benefit Health | $92 | 68% |
| Cmh Monroe County | $92 | 68% |
| Cmh Ionia County | $92 | 68% |
| Id County Payette | $92 | 68% |
| Mdwise | $92 | 68% |
| Ambetter / Centene | $92 - $118 | 68% |
| Iowa Total Care | $92 | 68% |
| Stephenson Cty Health | $92 | 68% |
| Presbyterian Centennial Care | $92 | 68% |
| Mo Home State Health Plan | $92 | 68% |
| Cmh Livingston County | $92 | 68% |
| Idaho Womens Health Check | $92 | 68% |
| Nebraska Total Care | $92 | 68% |
| Superior Health | $92 | 68% |
| Cardinal Innovations Lme | $92 | 68% |
| Delaware County Department of Health | $92 | 68% |
| City of Philadelphia | $92 | 68% |
| Tufts Health Public Plans | $92 | 68% |
| Cmh Clinton-Eaton-Ingham County | $92 | 68% |
| Philadelphia County Funding | $92 | 68% |
| Tenncare | $92 | 68% |
| Maryland Breast & Cervical Program | $92 | 68% |
| Dean Wi Badgercare | $92 | 68% |
| Id County Canyon | $92 | 68% |
| Id County Other | $92 | 68% |
| Peach State Healthplan | $92 | 68% |
| Texas Children's Health Plan | $92 | 68% |
| Ascension St. Vincent Public Safety Medical | $92 | 68% |
| Cmh Muskegon County | $92 | 68% |
| County Coroner | $92 | 68% |
| Cmh Berrien County | $92 | 68% |
| Cmh North Country | $92 | 68% |
| Cmh Detroit Wayne Integrated Health Network | $92 | 68% |
| Keystone First Chip | $92 | 68% |
| Family Health Network | $92 | 68% |
| Id County Ada | $92 | 68% |
| First Health | $92 | 68% |
| Oregon Screenwise | $92 | 68% |
| Amish Mennonite | $92 | 68% |
| Wi Womens Wellness | $92 | 68% |
| Sunshine State Health Plan | $92 | 68% |
| Cmh Montcalm County | $92 | 68% |
| Keystone First | $92 | 68% |
| Cmh Wayne Cty/Com Liv Svcs | $92 | 68% |
| Bccp | $92 | 68% |
| Healthy Blue Ne | $92 | 68% |
| Cmh Van Buren County | $92 | 68% |
| Cmh Central Mi County | $92 | 68% |
| St Joseph County Hlth Dpt | $92 | 68% |
| Cmh Washtenaw County | $92 | 68% |
| Partners Behavioral Lme | $92 | 68% |
| Chhuny | $92 | 68% |
| Cmh Kent County | $92 | 68% |
| Cmh Oakland County | $92 | 68% |
| Cmh Cass County | $92 | 68% |
| Washtenaw Health Plan | $92 | 68% |
| Dscc | $92 | 68% |
| Albany County Correctional Facility | $92 | 68% |
| Rx 340B Pass Along | $92 | 68% |
| Cmh West Mi County | $92 | 68% |
| Cenpatico | $92 | 68% |
| Cmh Kalamazoo | $92 | 68% |
| Harbor Health | $92 | 68% |
| Priority Partners | $92 | 68% |
| Breast Grant-Connecticut | $92 | 68% |
| Cmh Lenawee County | $92 | 68% |
| Cmh Allegan County | $92 | 68% |
| Screening for Life | $92 | 68% |
| Cmh Newaygo County | $92 | 68% |
| Lakeland Care Inc | $92 | 68% |
| Health Safety Net | $92 | 68% |
| Trillium Community Ohp | $92 | 68% |
| Prestige Health Choice | $92 | 68% |
| Intercommunity Health Ohp | $92 | 68% |
| Managed Health Services - Indiana | $92 | 68% |
| La Care Health Plan | $92 | 68% |
| Cmh Bay-Arenac County | $92 | 68% |
| Id County Cat Fund | $92 | 68% |
| Blue Shield - Ca | $105 | 77% |
| Blue Shield - Wa (Regence) | $105 | 77% |
| Blue Shield - Id (Regence) | $105 | 77% |
| Wc Domestic | $105 | 77% |
| Blue Shield - Ny Highmark Western | $105 | 77% |
| Blue Care Network | $105 | 77% |
| Blue Shield - PA (Highmark) | $105 | 77% |
| Bcn Domestic | $105 | 77% |
| Pre-Employment | $105 | 77% |
| Health Choices | $105 | 77% |
| Blue Distinction Transplant | $105 | 77% |
| Blue Benefit Administrators of Massachusetts | $105 | 77% |
| Kaiser Domestic | $105 | 77% |
| Blue Shield - Ny Highmark Northeastern | $105 | 77% |
| Delaware First Health | $110 | 81% |
| Wc Align Network | $134 | 99% |
| Wc Intermountain | $134 | 99% |
| Wc Allied | $134 | 99% |
| Wc Occ Health Allen | $134 | 99% |
| Wc Claims Mgmt Inc | $134 | 99% |
| Wc Tristar | $134 | 99% |
| Wc Taconic (Mro) | $134 | 99% |
| Wc Aims | $134 | 99% |
| Wc Idaho State Ins Fund | $134 | 99% |
| Wc Chubb | $134 | 99% |
| Njm Insurance Group | $134 | 99% |
| Wc Comp One Admin C/O Manageability | $134 | 99% |
| Wc Qualcare | $134 | 99% |
| Wc California State Comp Ins | $134 | 99% |
| Wc Taconic Farms | $134 | 99% |
| Wc Aegis | $134 | 99% |
| Wc Emc Insurance Company | $134 | 99% |
| Wc Ct Healthcare Trust | $134 | 99% |
| Wc Praxis Health Network | $134 | 99% |
| Wc New York | $134 | 99% |
| Wc Great West Casualty | $134 | 99% |
| Wc Hartford | $134 | 99% |
| Wc Donegal Insurance Group | $134 | 99% |
| Wc Enablecomp | $134 | 99% |
| Wc Nca Comp | $134 | 99% |
| Wc American Claims Mgmt | $134 | 99% |
| Wc Ohio Bureau | $134 | 99% |
| Wc Us Dept of Labor | $134 | 99% |
| East Greenbush Central School District | $134 | 99% |
| Wc Am Trust N America | $134 | 99% |
| Wc Health Management | $134 | 99% |
| Wc Massachusetts | $134 | 99% |
| Wc Smile Lodge | $134 | 99% |
| Genex Wc | $134 | 99% |
| Wc Alaska National Ins | $134 | 99% |
| Wc Amtrust | $134 | 99% |
| Wc Rev Claims | $134 | 99% |
| Wc Pma | $134 | 99% |
| Wc Procura Management | $134 | 99% |
| Wc Acuity | $134 | 99% |
| Wc City of Albany | $134 | 99% |
| Rx Worker's Comp | $134 | 99% |
| Wc Chartis | $134 | 99% |
| Wc Benetech | $134 | 99% |
| Wc City of Sioux City | $134 | 99% |
| Wc Price Chopper | $134 | 99% |
| Wc New York Special Funds | $134 | 99% |
| Wc Memic | $134 | 99% |
| Wc Broward County | $134 | 99% |
| Wc Fed Ex | $134 | 99% |
| Wc Society | $134 | 99% |
| Wc Evolutions | $134 | 99% |
| Wc Key Ins & Benefit Solutions | $134 | 99% |
| Jag Source | $134 | 99% |
| Wc Hastings | $134 | 99% |
| Wc Asu Risk Mgt | $134 | 99% |
| Wc Northeast Health | $134 | 99% |
| Wc Fresno Unified Emp | $134 | 99% |
| Wc Mdia | $134 | 99% |
| Wc Gallagher Bassett | $134 | 99% |
| Wc Ccmsi | $134 | 99% |
| Wc Generic | $134 | 99% |
| Wc Winnebago Industries | $134 | 99% |
| Wc York Risk | $134 | 99% |
| Wc Michigan | $134 | 99% |
| Rx Restat | $134 | 99% |
| Wc Employee Mutual | $134 | 99% |
| Wc General Motors | $134 | 99% |
| Wc Secura | $134 | 99% |
| Wc Sedgwick | $134 | 99% |
| Wc Walmart | $134 | 99% |
| Wc Saif Oregon | $134 | 99% |
| Wc North American Rishces | $134 | 99% |
| Wc One Call Medical | $134 | 99% |
| Wc Reny Company | $134 | 99% |
| Wc Velocity | $134 | 99% |
| Wc Heritage Summit | $134 | 99% |
| Rx Heatlhcomp | $134 | 99% |
| Wc Mra | $134 | 99% |
| Wc Peerless | $134 | 99% |
| Wc Yankee Trails | $134 | 99% |
| Wc Horizon | $134 | 99% |
| Wc Fcci | $134 | 99% |
| Wc Meijers | $134 | 99% |
| Wc Aig | $134 | 99% |
| Wc Novanet | $134 | 99% |
| Wc Genex Care for Ohio | $134 | 99% |
| Wc Encore Health Network | $134 | 99% |
| Wc Berkley Admin | $134 | 99% |
| Wc Johns Eastern | $134 | 99% |
| Wc Esis | $134 | 99% |
| Wc Finley Occupational Health | $134 | 99% |
| Wc Travelers | $134 | 99% |
| Wc Ace | $134 | 99% |
| Wc Liberty Mutual | $134 | 99% |
| Rx Saif Opdp Wc | $134 | 99% |
| Wc Advantage | $134 | 99% |
| Wc Guard Insurance Company | $134 | 99% |
| Wc Triad Group | $134 | 99% |
| Wc Federal Black Lung | $134 | 99% |
| Wc Zenith | $134 | 99% |
| Wc Troy Ny | $134 | 99% |
| Wc Medical Administrators | $134 | 99% |
| Wc Michigan Millers Mutual | $134 | 99% |
| Wc Mercy Workcare | $134 | 99% |
| Wc Nationwide | $134 | 99% |
| Wc Mac Risk Management | $134 | 99% |
| Wc Meadowbrook Claim | $134 | 99% |
| Wc West Bend Mutual/Argent | $134 | 99% |
| Wc Capitol Area Health Consortium | $134 | 99% |
| Wc Ford Motor | $134 | 99% |
| Wc Erie | $134 | 99% |
| Wc Unified Health Services | $134 | 99% |
| Wc United Heartland | $134 | 99% |
| Wc Compone Admin | $134 | 99% |
| Wc Cna | $134 | 99% |
| Wc Sheakley Unicomp | $134 | 99% |
| Wc West Bend | $134 | 99% |
| Wc Kemberton | $134 | 99% |
| Wc Federated | $134 | 99% |
| Wc Rural Mutual | $134 | 99% |
| Wc Tyson | $134 | 99% |
| Wc O'Hara Corp | $134 | 99% |
| Wc Bunch & Associates | $134 | 99% |
| Wc California State Ins Fund | $134 | 99% |
| Wc Hireright | $134 | 99% |
| Wc Broadspire | $134 | 99% |
| Wc Accident Fund | $134 | 99% |
| Wc Icw Group | $134 | 99% |
| Wc Guarantee Insurance | $134 | 99% |
| Wc Acs Federal Employees | $134 | 99% |
| Wc Risico | $134 | 99% |
| Wc Zurich | $134 | 99% |
| Wc Srs | $134 | 99% |
| Wc Paradigm | $134 | 99% |
| Wc Quiktrip | $134 | 99% |
| New York State Insurance Fund | $134 | 99% |
| Wc Hab | $134 | 99% |
| Wc Notre Dame | $134 | 99% |
| Wc Mitchell Frankenmuth | $134 | 99% |
| Wc Sentry | $134 | 99% |
| Wc Intercare Insurance | $134 | 99% |
| Healthsmart Workers Comp | $134 | 99% |
| Wc First Agency/Occunet | $134 | 99% |
| Andrie Inc | $134 | 99% |
| Wc Amerisure | $134 | 99% |
| Wc Cirma | $134 | 99% |
| Asrm - Reliance Standard Life Insurance | $170 - $176 | 125% |
| Medi Share | $170 - $176 | 125% |
| Devon Health Services | $170 - $176 | 125% |
| PHCS | $170 - $176 | 125% |
| Manhattan Life | $170 - $176 | 125% |
| Dean Health | $170 - $176 | 125% |
| Pai | $170 - $176 | 125% |
| Lifetime Benefit Solutions | $170 - $176 | 125% |
| Trinity Health Share | $170 - $176 | 125% |
| Allied National Global Care | $170 - $176 | 125% |
| Family Life Insurance Company | $170 - $176 | 125% |
| Fallon Health | $170 - $176 | 125% |
| Christian Care Ministry | $170 - $176 | 125% |
| Pan-American Life | $170 - $176 | 125% |
| International Benefit Administrators | $170 - $176 | 125% |
| Ghc Scw | $170 - $176 | 125% |
| Paramount HMO | $170 - $176 | 125% |
| Multiplan | $170 - $176 | 125% |
| Meritain | $173 | 128% |
| Coventry | $173 | 128% |
| Vitalcore | $180 - $186 | 133% |
| Three Rivers Provider Network | $190 - $197 | 140% |
| Galaxy Health Network | $190 - $197 | 140% |
| Prime Health Services | $190 - $197 | 140% |
| Wc Corvel | $190 - $197 | 140% |