Itemized  ·  Procedures  ·  Office visit, established patient, level 4

Office visit, established patient, level 4 cost.

What office visit, established patient, level 4 costs at 127 US hospitals across 56 metros, pulled from the federally-mandated machine-readable files each hospital is required to publish. Cash-pay range: $20 to $2,367 (118× spread). CPT code 99214.

Cheapest cash price
$20
Children's Hospital Los Angeles
Los Angeles, CA
vs.
Most expensive cash price
$2,367
Heart Hospital of Austin
Austin, TX

Top 5 cheapest hospitals for office visit (level 4).

# Hospital Cash price
1
Children's Hospital Los Angeles
Los Angeles, CA
 $20
2
Adventist Health Glendale
Glendale, CA
 $31 to $140
3
Adventist Health White Memorial Montebello
Montebello, CA
 $36 to $54
4
Rady Children's Hospital San Diego
San Diego, CA
 $36 to $1,173
5
Loyola University Medical Center
Maywood, IL
 $38 to $42

See all 127 hospitals, your insurance, your zip.

Pick your insurance plan, enter your zip, see your estimated out-of-pocket cost. Same data, your view.

Compare office visit (level 4) prices →

What is office visit, established patient, level 4?

Office visit, established patient, level 4.

Higher-acuity than 99213 — 30-40 minutes, more complex medical decision-making. Common when managing multiple chronic conditions, medication adjustments, or significant symptom changes.

The step up from 99213 to 99214 is one of the most-watched billing patterns in healthcare. If your visit was straightforward (new prescription, brief check-in) and you got billed 99214 instead of 99213, that's worth asking about.

Why prices vary this much.

The same office visit, established patient, level 4 on the same equipment can cost 118 times more at one hospital than another. Three reasons.

Chargemasters are arbitrary. The "sticker price" hospitals publish was never designed for consumers. It's a starting number for negotiation with insurance companies, with adjustments stacked on top for decades. Almost no one pays the chargemaster.

Negotiated rates are confidential bilateral contracts. Each insurance company negotiates its own rate with each hospital. Aetna at Hospital A might pay 60% of what Cigna pays at the same hospital for the same code. You see one rate; the hospital sees dozens.

Cash pay is a separate thing entirely. Many hospitals offer a "self-pay" or "cash-pay" rate that's dramatically cheaper than what they'd bill insurance, especially for elective imaging. If you have a high-deductible plan, paying cash and filing for reimbursement (or just eating the cost) can be the cheapest path.

What to ask the hospital before you book.

The four questions that surface hidden costs:

1. "Is the price you're quoting me the all-in price, or just the facility fee?" Hospitals often quote the facility fee and bill the radiologist or anesthesiologist separately on a different invoice.

2. "What's the cash-pay rate vs the rate you'd bill my insurance?" Don't assume insurance is cheaper. For high-deductible plans, cash pay is often the better deal.

3. "If I'm uninsured, do you have a financial assistance policy I qualify for?" Federally-tax-exempt hospitals are required to have one, and it can knock 50-100% off the bill for households under specific income thresholds.

4. "If I get a bill and the price is different than what was quoted, what's your dispute process?" Get the answer before you book, in writing if possible. If the bill comes in higher than the quote, you have leverage.

Common questions.

How much does office visit, established patient, level 4 cost in 2026?+
Cash-pay prices for office visit, established patient, level 4 (CPT 99214) range from $20 to $2,367 across the 127 hospitals in our dataset. The price varies by hospital, payer, and whether you pay cash or use insurance. Cash-pay rates are often dramatically cheaper than the rate insurance would pay at the same hospital, which is one of the more uncomfortable truths in this data.
Why does office visit, established patient, level 4 cost so much more at some hospitals than others?+
Three reasons. First, hospital chargemasters (the "sticker price") are largely arbitrary and were never designed for consumers. Second, hospitals in expensive real-estate markets (Manhattan, San Francisco, Boston) carry higher facility overhead. Third, the negotiated rate each insurance company pays is the result of confidential bilateral contracts, so the same procedure on the same machine can cost 5x more depending on which insurance card you hand over.
Is the cash price always the cheapest option?+
Not always, but more often than you'd expect. For office visit, established patient, level 4 in our dataset, the cash price beats the negotiated insurance rate at many hospitals, especially for patients with high-deductible plans. Always ask the hospital for both numbers before you decide which to use. If you have a low-deductible plan and the procedure is in-network, insurance is usually still cheaper.
What does the published price include?+
For office visit, established patient, level 4 (CPT 99214), the published rate generally includes the procedure itself plus the immediately associated facility and professional fees as the hospital has assigned them. It does NOT include separate physician consultations, follow-up visits, prescriptions, or any complications that require additional treatment. Always ask: "Is this the all-in price, or just the facility fee?"
Where does this data come from?+
Federal law (45 CFR 180.50, the Hospital Price Transparency Rule) requires every US hospital to publish a machine-readable file with their negotiated rates and cash prices. We download those files directly from each hospital, parse them, and present them in a comparable format. No surveys, no estimates, no scraped review sites. The data is current as of the latest publication date for each hospital.