Office visit, established patient (30-39 min)
Facility: University Medical Center of Princeton at Plainsboro
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $514
- Cash Discount Price: $643
- vs. Medicare Baseline: 3.79x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 379% of the Medicare baseline (a markup of 279%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Horizon Nj Health | $58 | 43% |
| Medicaid / KanCare | $59 - $643 | 44% |
| Magellan | $59 | 44% |
| Aetna | $59 - $536 | 44% |
| Amerihealth | $59 | 44% |
| Charity Care | $60 | 44% |
| Wellcare | $65 | 48% |
| Blue Cross Blue Shield | $129 - $484 | 95% |
| Preferred Health Care Eliance | $167 | 123% |
| Us Family Health Plan | $225 | 166% |
| Claim Watcher | $225 | 166% |
| Horizon Behavioral Health | $241 | 178% |
| Beacon Health Options | $322 | 237% |
| Magnacare | $386 - $450 | 285% |
| Princeton Theological Seminary | $418 | 308% |
| Coventry | $450 | 332% |
| Health Net | $450 | 332% |
| UnitedHealthcare | $482 | 355% |
| Intergrated Health Plan | $514 | 379% |
| Penn Global Medicine Embassy Only | $514 | 379% |
| Intergroup | $514 | 379% |
| Beech Street | $514 - $547 | 379% |
| Allied Trades | $547 | 403% |
| First Managed Care Option | $547 | 403% |
| Private Healthcare Systems | $547 | 403% |
| Devon Health Services | $547 | 403% |
| Qualcare | $547 | 403% |
| Consumer Health Network | $547 | 403% |
| Total Care Network | $547 | 403% |
| Ie Shaffer | $547 | 403% |
| Tri-State | $547 | 403% |
| Elap | $643 | 474% |
| Clover Health Plan | $643 | 474% |
| Personnel Health Program | $643 | 474% |
| Centivo | $643 | 474% |
| Commercial Other | $643 | 474% |
| International Pfs | $643 | 474% |
| Cigna | $643 | 474% |
| Life St. Francis | $643 | 474% |
| United Behavioral Health | $643 | 474% |
| Tricare | $643 | 474% |
| VA Medical Center | $643 | 474% |
| Penn Behavioral Health Corporate Services | $643 | 474% |
| Nj Carpenters | $643 | 474% |
| Compsych | $643 | 474% |
| Concern Plus | $643 | 474% |
| Managed Health Network | $643 | 474% |