Price Checker / CPT 99214
How much does Office visit — detailed (established patient) cost?
CPT 99214 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 10x the fair price — among the most extreme markups. Dispute this.
Fair price
$330–$390
What this should cost
With insurance
~$317,400
Typical out-of-pocket
Overcharged if over
$490
Push back above this
The average hospital charge of $3,671 is $3,311 over the fair price (about 10x the fair rate).
What hospitals charge for Office visit — detailed (established patient)
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Long Island Jewish Valley Stream , NY | — | $13,799 | 20251% |
| Phelps Hospital SLEEPY HOLLOW, NY | — | $14,305 | 15301% |
| North Arkansas Regional Medical Center Harrison, AR | $17,974 | — | 11166% |
| PeaceHealth Ketchikan Medical Center KETCHIKAN, AK | $275 | — | 4121% |
| Columbus Springs Dublin , OH | $2,921 | — | 2054% |
| Phelps Health , MO | $4,378 | — | 1759% |
| Rainier Springs VANCOUVER, WA | $125 | — | 907% |
| Copper Springs , AZ | $125 | — | 775% |
| UPMC Western Psychiatric , PA | $392 | $314 | 189% |
| Northeast Texas Rural Health Clinic Mt. Pleasant, TX | $350 | — | 106% |
| Northeastern Center AUBURN, IN | $236 | — | 74% |
| Connally Memorial Health Centers - Main Campus Floresville, TX | $127 | — | 62% |
| Pine Rest Christian Mental Health Services GRAND RAPIDS, MI | $204 | $163 | 50% |
| Connally Memorial Health Centers - North Campus Floresville, TX | $127 | — | 39% |
| JD McCarty Center Norman, OK | $150 | — | 35% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Office visit — detailed (established patient)
CPT code 99214 refers to office visit — detailed (established patient) (billing description: "Office o/p est mod 30 min"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $85 in a facility (hospital or surgery center) and $136 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.