Wesley Derby ER · Derby, KS
Office visit established patient level 4
Procedure code (CPT) 99214 · Office visit · Hospital's own wording: "OP VISIT LEVEL 4 EST"
| Cash price | $1,001 — the discounted cash price in the hospital's published file. |
|---|---|
| List price | $1,001 — the hospital's gross (list) charge before any discount or insurance. |
| Medicare rate (2026) | $84.50 — Medicare’s published national payment rate for this procedure (CMS Physician Fee Schedule, facility rate). It is a total rate: for most services Medicare pays about 80% of it and the patient or their supplemental plan about 20%. The amount paid to a specific hospital varies with local wage adjustments. |
| Insurance-negotiated range | $143.14 – $900.90 — the lowest and highest rates this hospital has negotiated with insurance plans for this procedure, as published in its file. |
The low end of a negotiated range can reflect a government program fee schedule (such as Medicaid) rather than a rate most patients would pay, and the high end can reflect contract formulas. Your own plan's rate sits somewhere inside the range and depends on your coverage.
Where this price comes from
These figures are taken word-for-word from Wesley Derby ER's own published price file, file date September 1, 2026. Open the hospital's source file. Prices are published figures, not a quote or a guarantee of your final bill — see how to read these numbers.
Same procedure at other covered hospitals
- Allen County Regional Hospital (Iola, KS) — cash $54
- Anderson County Hospital (Garnett, KS) — cash $54
- Hedrick Medical Center (Chillicothe, MO) — cash $54
- Wright Memorial Hospital (Trenton, MO) — cash $54
- Cox Medical Center North (Springfield, MO) — cash $58.52
- Cox Medical Center South (Springfield, MO) — cash $58.52
- Meyer Orthopedic and Rehabilitation Hospital (Springfield, MO) — cash $58.52
- Liberty Hospital (Liberty, MO) — cash $63
- Cox Barton County Hospital (Lamar, MO) — cash $74.08
- The University of Kansas Health System Paola Hospital (Paola, KS) — cash $79.93
- The University of Kansas Health System Great Bend Campus (Great Bend, KS) — cash $97.65
- Hays Medical Center (Hays, KS) — cash $122.10
- Cox Medical Center Branson (Branson, MO) — cash $124.27
- Mercy Hospital Carthage (Carthage, MO) — cash $124.80
- Mercy Hospital Springfield (Springfield, MO) — cash $130.65
- Mercy Orthopedic Hospital Springfield (Ozark, MO) — cash $130.65
- Mercy Hospital Perry (Perryville, MO) — cash $135.20
- Wamego Health Center (Wamego, KS) — cash $137.20
- Mercy Hospital Aurora (Aurora, MO) — cash $139.10
- Mercy Hospital Columbus (Columbus, KS) — cash $153.40
- Mercy Specialty Hospital - Southeast Kansas (Galena, KS) — cash $156
- Boone Hospital Center (Columbia, MO) — cash $159.60
- Cox Monett Hospital (Monett, MO) — cash $166.97
- Mercy Hospital Cassville (Cassville, MO) — cash $169
- Mercy Hospital Joplin (Joplin, MO) — cash $169
- Mercy Hospital Lebanon (Lebanon, MO) — cash $169.65
- Mercy St Francis Hospital (Mountain View, MO) — cash $171.60
- Saint Luke's East Hospital (Lee's Summit, MO) — cash $178.80
- Saint Luke's North Hospital (Kansas City, MO) — cash $178.80
- Saint Luke's South Hospital (Overland Park, KS) — cash $178.80
- Saint Luke’s North Hospital – Smithville (Smithville, MO) — cash $178.80
- Ascension Via Christi Hospital Manhattan (Manhattan, KS) — cash $192.40
- Saint Luke's Hospital of Kansas City (Kansas City, MO) — cash $195
- Mercy Hospital Pittsburg (Pittsburg, KS) — cash $198.25
- Mercy Hospital Lincoln (Troy, MO) — cash $201.50
- Children's Mercy Hospital Kansas (Overland Park, KS) — cash $205.92
- Children's Mercy Kansas City Adele Hall Campus (Kansas City, MO) — cash $205.92
- Hannibal Regional Hospital (Hannibal, MO) — cash $210
- Mercy Hospital Washington (Washington, MO) — cash $210.60
- Mosaic Life Care at St Joseph Medical Center (St. Joseph, MO) — cash $212.50
- Mercy Hospital South (Saint Louis, MO) — cash $221.65
- Bothwell Regional Health Center (Sedalia, MO) — cash $227.25
- Lafayette Regional Health Center (Lexington, MO) — cash $229.39
- Mercy Hospital St Louis (Saint Louis, MO) — cash $237.25
- Heartland Long Term Acute Hospital (St. Joseph, MO) — cash $255
- Mosaic Medical Center - Maryville (Maryville, MO) — cash $255
- Mosaic Medical Center Albany (Albany, MO) — cash $255
- Salina Regional Health Center (Salina, KS) — cash $399
- Belton Regional Medical Center (Belton, MO) — cash $436.43
- Mercy Rehabilitation Hospital St Louis (Chesterfield, MO) — cash $520.90
- Mercy Hospital Jefferson (Festus, MO) — cash $571.35
- Mercy Hospital Southeast (Cape Girardeau, MO) — cash $635.70
- Mercy Hospital Stoddard (Dexter, MO) — cash $635.70
- Research Psychiatric Center (Kansas City, MO) — cash $670.89
- Mercy Rehabilitation Hospital Springfield (Springfield, MO) — cash $752.58
- ER of Olathe (Olathe, KS) — cash $982.64
- ER of Shawnee (Shawnee, KS) — cash $982.64
- Overland Park Regional Medical Center (Overland Park, KS) — cash $982.64
- Wesley Medical Center (Wichita, KS) — cash $1,001
- Wesley Rehabilitation Center (Wichita, KS) — cash $1,001
- Wesley West (Wichita, KS) — cash $1,001
- Wesley Woodlawn Hospital & ER (Wichita, KS) — cash $1,001
- ER of Brookside (Kansas City, MO) — cash $1,424.25
- Research Medical Center (Kansas City, MO) — cash $1,424.25
- Menorah Medical Center (Overland Park, KS) — cash $1,450.30
- Centerpoint Medical Center (Independence, MO) — cash $1,684.50
- Lee's Summit Medical Center (Lee's Summit, MO) — cash $1,710.21
- Ascension Via Christi Hospital St. Teresa (Wichita, KS) — cash Not published
- Ascension Via Christi Rehabilitation Hospital (Wichita, KS) — cash Not published
- Ascension Via Christi St. Francis (Wichita, KS) — cash Not published
- Ascension Via Christi St. Joseph (Wichita, KS) — cash Not published
- Freeman Hospital East Campus Acute Rehab (Joplin, MO) — cash Not published
- Freeman Hospital East Campus Inpatient Geri Psych (Joplin, MO) — cash Not published
- Freeman Hospital East Campus Inpatient Psych (Joplin, MO) — cash Not published
- Freeman Hospital West Campus Acute Inpatient Hospital (Joplin, MO) — cash Not published
- Freeman Neosho Hospital Inpatient Critical Access (Neosho, MO) — cash Not published
- Freeman Neosho Hospital Inpatient Swing Bed (Neosho, MO) — cash Not published
- Stormont Vail Flint Hills Campus (Junction City, KS) — cash Not published
- Stormont Vail Hospital (Topeka, KS) — cash Not published
