CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mount Desert Island Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $102
Cash Discount Price: $188
vs. Medicare Baseline: 0.75x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mount Desert Island Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $188. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.75x the Medicare baseline. Located in 10 Wayman Lane, Bar Harbor, ME.

Cash / Self-Pay

$188

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $188 (139%)

Insurance Median: $102 (75%)

Cash: $188 (139% of Medicare)

Ins. Median: $102 (75% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Cigna	$23 - $262	17%
Wellcare	$23 - $127	17%
Blue Cross Blue Shield	$23 - $219	17%
UnitedHealthcare	$23 - $169	17%
Aetna	$23 - $258	17%
Martins Point	$23 - $127	17%
Healthnet	$34 - $183	25%
Community Health Options	$44 - $240	32%
Harvard Pilgrim	$47 - $255	35%
First Health	$49 - $268	36%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $188.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mount Desert Island Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.