CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Riverside Community Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $215
  • Cash Discount Price: $718
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Riverside Community Hospital is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $718. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.59x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.
Cash / Self-Pay
$718

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $718 (529%)
Insurance Median: $215 (159%)
Cash: $718 (529% of Medicare)
Ins. Median: $215 (159% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
La Care Health $54 40%
Molina $54 40%
Brand New Day $59 44%
Aetna $72 - $129 53%
Inland Empire Health Plan $78 58%
Medcare Partners $108 80%
Health Net $160 118%
United $189 139%
Redlands Community $215 159%
Blue Shield $230 - $372 170%
First Health $316 - $646 233%
American Health System $323 238%
Riverside Medical Clinic $467 344%
Riverside Physician $467 344%
Healthsmart $574 423%
Multiplan $574 - $610 423%
Next $574 423%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4445 Magnolia Avenue, Riverside, CA 92501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals