CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Santa Clara Valley Medical Center

Billing Code: 99214 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$130
about 1.0× the $136 Medicare rate · typically $69–$234
modeled estimate · not a bill or quote
What this hospital charges insurers
$112
Below the fair price — a good deal
about $18 under the fair price · 0.8× Medicare
Medicare pays $136 Fair price $130 This hospital $112 Cash price $543 Hospital's list price $775

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $38 Priciest $112

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Office visit, established patient (30-39 min) is about $130 (about 1.0× the $136 Medicare rate). Santa Clara Valley Medical Center charges insurers about $112, or about $543 in cash — below the fair price — a good deal. Located in San Jose, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $134 99%
Blue Cross Blue Shieldmajor $169 125%
Aetnamajor $93 69%
Cignamajor $155 114%
Health Net $112 83%
+ 2 smaller / regional plans $44 - $112
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 751 South Bascom Avenue, San Jose, CA 95128
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals