CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Mercy St Francis Hospital
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $244
- Cash Discount Price: $174
- vs. Medicare Baseline: 1.80x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercy St Francis Hospital is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.80x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.
Cash / Self-Pay
$174
Average discount available for prompt cash payment at this facility.
Insurance Median
$244
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: $174 (128%)
Insurance Median: $244 (180%)
Cash: $174 (128% of Medicare)
Ins. Median: $244 (180% 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 | $66 - $141 | 49% |
| UnitedHealthcare | $72 - $257 | 53% |
| Kindful Hospice [20434] | $73 - $91 | 54% |
| Provider Partners Health Plans Contracted [320450] | $73 - $91 | 54% |
| Indian Health Service Contracted [320198] | $73 - $91 | 54% |
| Kindful Hospice Contracted [320434] | $73 - $91 | 54% |
| Globalhealth Contracted [320145] | $73 - $91 | 54% |
| Qual Choice Contracted [320325] | $73 - $91 | 54% |
| Elara Caring Aspire Hospice [20433] | $73 - $91 | 54% |
| Cross Timbers Hospice [20098] | $73 - $91 | 54% |
| Humana | $73 - $244 | 54% |
| Mercy Hospice Okc [20252] | $73 - $91 | 54% |
| Cherokee Nation Health Serv Contracted [320066] | $73 - $91 | 54% |
| Blue Cross Blue Shield | $73 - $263 | 54% |
| Cigna | $73 - $257 | 54% |
| Acentra Health Contracted [320527] | $73 - $86 | 54% |
| Medicare (plans) | $73 - $97 | 54% |
| Aetna | $73 - $241 | 54% |
| Halo Hcr Inc Hospice Contracted [320432] | $73 - $91 | 54% |
| Pace of the Ozarks Contracted [320518] | $73 - $91 | 54% |
| Halo Hcr Inc Hospice [20432] | $73 - $91 | 54% |
| Mercy Mgd Behavioral Health Contracted [320259] | $73 - $91 | 54% |
| Medical Associates Health Contracted [320444] | $73 - $91 | 54% |
| Dept of Veteran Affairs Contracted [320106] | $73 - $93 | 54% |
| Healthscope Contracted [320182] | $87 - $120 | 64% |
| Tricare | $90 - $92 | 66% |
| Administrative Payor Contracted [320005] | $119 - $122 | 88% |
| Centivo Contracted [320505] | $120 - $157 | 88% |
| Ambetter / Centene | $137 - $141 | 101% |
| Home State Health Plan Contracted [320187] | $137 - $141 | 101% |
| Novasys Contracted [320285] | $137 - $141 | 101% |
| Healthlink Contracted [320179] | $172 - $257 | 127% |
| Preferred Health Plan Contracted [320522] | $172 - $176 | 127% |
| Workers Comp [20426] | $211 - $230 | 156% |
| Point C Contracted [320238] | $238 - $257 | 176% |
| Auxiant Contracted [320462] | $238 - $257 | 176% |
| United Medical Resources Contracted [320454] | $238 - $252 | 176% |
| Mercy Benefit Admin Contracted [320251] | $238 - $257 | 176% |
| Medica Contracted [320239] | $249 - $256 | 184% |
| Edison Health Solutions Contracted [320502] | $251 - $257 | 185% |
| Multiplan Contracted [320270] | $251 - $257 | 185% |
| USA Managed Care Org Contracted [320429] | $251 - $257 | 185% |
| Imagine 360 Contracted [320494] | $251 - $257 | 185% |
| Evolutions Health Care Contracted [320124] | $251 - $257 | 185% |
| First Health Contracted [320128] | $251 - $257 | 185% |
| Aither Health Contracted [320449] | $251 - $257 | 185% |
| Reflect Health Contracted [320492] | $251 - $257 | 185% |
| Show-Me Health Administrators Contracted [320483] | $251 - $257 | 185% |
| Private Health Care Systems Contracted [320320] | $251 - $257 | 185% |
| Health Systems Inc Contracted [320174] | $251 - $257 | 185% |
| Point C [20238] | $251 - $257 | 185% |
| 90 Degree Benefits Contracted [320436] | $251 - $257 | 185% |
| Yuzu Health Contracted [320521] | $251 - $257 | 185% |
| Insurance System Inc Contracted [320465] | $251 - $257 | 185% |
| Benefit Management Contracted [320052] | $251 - $257 | 185% |
| Ebms Contracted [320493] | $251 - $257 | 185% |