CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Oak Valley Hospital District

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $97
  • Cash Discount Price: $174
  • vs. Medicare Baseline: 0.83x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Oak Valley Hospital District is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.83x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.
Cash / Self-Pay
$174

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $174 (148%)
Insurance Median: $97 (83%)
Cash: $174 (148% of Medicare)
Ins. Median: $97 (83% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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
Alignment Op Only Ip/Op Only-All Plans $71 60%
Humana $71 60%
Kaiser Mcr Adv Ip/Op Only $71 60%
Scan Health Plan Ip/Op Only-All Plans $73 62%
Imperial Health Ip/Op Only-All Plans $78 66%
Healthnet Comm Op Only Ip/Op Only-All Other Plans $81 - $192 69%
Blue Cross Blue Shield $82 - $293 70%
Healthnet Medi-Cal Ip/Op Only $82 70%
Kaiser Medi-Cal Ip/Op Only $82 70%
Medi-Cal Ip/Op Only $82 70%
UnitedHealthcare $83 - $196 71%
Kaiser Comm Ip/Op Only-All Other Plans $86 - $202 73%
Blue Shield Epn Ip/Op Only $88 75%
Cigna $92 - $218 78%
Hp Of San Joaquin Ip/Op Only-All Plans $98 83%
Aetna $117 - $277 100%
Blue Shield/Bcout Ip/Op Only-All Other Plans $124 - $293 105%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 350 S Oak Ave, Oakdale, CA 95361
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals