CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: El Centro Regional Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $210
  • Cash Discount Price: $172
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at El Centro Regional Medical Center is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.55x the Medicare baseline. Located in 1415 Ross Avenue, El Centro, CA.
Cash / Self-Pay
$172

Average discount available for prompt cash payment at this facility.

Insurance Median
$210

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: $172 (127%)
Insurance Median: $210 (155%)
Cash: $172 (127% of Medicare)
Ins. Median: $210 (155% 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
Blue Cross Blue Shield $85 - $313 63%
Brand New Day Comm - All Other Plans $85 63%
Brand New Day Mcr $85 63%
Healthnet Mcr Adv $85 63%
Molina Mcr Adv $85 63%
Scp Managed Care - All Plans $85 63%
Tricare $85 63%
UnitedHealthcare $85 - $234 63%
Aetna $92 - $205 68%
Easy Choice Mcr Adv-All Plans $93 69%
Healthnet Hmo $106 78%
Cdcr Correctional-All Plans $110 81%
Pacificare-All Plans $130 - $289 96%
Blue Shield-All Plans $137 - $297 101%
Mulitplan Primary - All Other Plans $143 - $317 105%
Cigna $158 - $350 117%
Multiplan Comp $168 - $373 124%
Trident - All Plans $178 - $396 131%
Healthnet Comm-All Other Plans $189 - $419 139%
Humana $195 - $433 144%
Ahccs/Medi-Cal Misc - All Plans $210 - $466 155%
Brand New Day Mcal $210 - $466 155%
Medi-Cal $210 - $466 155%
Molina Exchange - All Other Plans $210 - $466 155%
Ambetter / Centene $216 - $480 159%
Molina Mcal $231 - $513 170%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1415 Ross Avenue, El Centro, CA 92243
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals