Office visit, established patient (30-39 min)
Facility: Mercy Hospital of Buffalo
Billing Code: 99214 (CPT)
- CPT Billing Code: 99214
- Insurance Median: $112
- Cash Discount Price: $235
- vs. Medicare Baseline: 0.83x 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 | $36 - $156 | 27% |
| Amerigroup [350102] | $36 - $112 | 27% |
| Medicare (plans) | $80 - $130 | 59% |
| Medicaid / KanCare | $80 - $124 | 59% |
| Beacon Essential [350122] | $80 - $112 | 59% |
| Beacon Health Options [100023] | $80 - $112 | 59% |
| Univera Healthcare Essential [100170] | $86 - $101 | 63% |
| Univera Healthcare [100169] | $86 - $138 | 63% |
| UnitedHealthcare | $93 - $124 | 69% |
| Federal Workers Compensation [500100] | $94 - $102 | 69% |
| Hospice [550001] | $94 - $124 | 69% |
| Independent Health Essential [100166] | $96 - $112 | 71% |
| Tuscarora Nation [550120] | $96 - $112 | 71% |
| Crime Victims [100176] | $96 - $112 | 71% |
| Vna Option Mltc [350110] | $96 - $112 | 71% |
| Excellus Rochester McD [350117] | $96 - $112 | 71% |
| Fidelis Dual Advantage [450120] | $98 - $130 | 72% |
| Wellcare Fidelis Dual [450451] | $98 - $130 | 72% |
| Mvp Healthcare [100168] | $100 - $118 | 74% |
| No Fault [114001] | $102 | 75% |
| VA Veterans Affairs [700001] | $105 - $124 | 77% |
| Champ VA [700002] | $105 - $124 | 77% |
| Covid19 Hrsa [45013] | $105 - $124 | 77% |
| Cigna | $105 - $180 | 77% |
| UPMC Health Plan [100181] | $105 | 77% |
| Seneca Nation [450119] | $105 - $124 | 77% |
| Tricare | $105 - $124 | 77% |
| Fallon Health [450115] | $105 - $124 | 77% |
| Fidelis Essential [100163] | $111 - $149 | 82% |
| Humana | $111 - $124 | 82% |
| Iha First Choice [800001] | $114 - $134 | 84% |
| Independent Health [100165] | $114 - $134 | 84% |
| Wellcare [450129] | $116 - $136 | 86% |
| Magnacare [100142] | $124 | 91% |
| Meritain [100063] | $124 | 91% |
| Aetna | $124 | 91% |
| Catholic Health Life Pace [400005] | $124 | 91% |
| Ghi [100153] | $136 | 100% |
| Fidelis Exchange [100164] | $149 | 110% |
| Molina Essential [100167] | $253 | 187% |