CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Oak Valley Hospital District

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $158
  • Cash Discount Price: $201
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Oak Valley Hospital District is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $201. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.17x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.
Cash / Self-Pay
$201

Average discount available for prompt cash payment at this facility.

Insurance Median
$158

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: $201 (148%)
Insurance Median: $158 (117%)
Cash: $201 (148% of Medicare)
Ins. Median: $158 (117% 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 $54 - $241 40%
Healthnet Medi-Cal Ip/Op Only $54 40%
Kaiser Medi-Cal Ip/Op Only $54 40%
Medi-Cal Ip/Op Only $54 40%
Hp Of San Joaquin Ip/Op Only-All Plans $65 48%
Alignment Op Only Ip/Op Only-All Plans $85 63%
Humana $85 63%
Kaiser Mcr Adv Ip/Op Only $85 63%
Scan Health Plan Ip/Op Only-All Plans $87 64%
Blue Shield Epn Ip/Op Only $88 65%
Imperial Health Ip/Op Only-All Plans $93 69%
Healthnet Comm Op Only Ip/Op Only-All Other Plans $158 117%
UnitedHealthcare $161 119%
Kaiser Comm Ip/Op Only-All Other Plans $166 122%
Cigna $180 133%
Aetna $228 168%
Blue Shield/Bcout Ip/Op Only-All Other Plans $241 178%

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