CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Saint Agnes Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $83
  • Cash Discount Price: $33
  • vs. Medicare Baseline: 0.61x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Saint Agnes Medical Center is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.61x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$33

Average discount available for prompt cash payment at this facility.

Insurance Median
$83

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: $33 (24%)
Insurance Median: $83 (61%)
Cash: $33 (24% of Medicare)
Ins. Median: $83 (61% 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
Aetna $14 - $106 10%
Geha $14 - $90 10%
Medicare (plans) $14 - $89 10%
Meritain $14 - $90 10%
Multiplan $14 - $86 10%
Phcs $14 - $86 10%
UnitedHealthcare $14 - $106 10%
Veterans Administration $14 - $85 10%
Welbe Health $14 - $87 10%
Champva $15 - $95 11%
Humana $15 - $95 11%
Tricare $15 - $95 11%
Triwest Health Alliance $15 - $95 11%
Us Family Health Plan $15 - $95 11%
Veterans Eval Services $15 - $95 11%
Align Senior Care $16 - $98 12%
Coventry $16 - $102 12%
First Health $16 - $102 12%
Medicaid / KanCare $16 - $93 12%
Blue Cross Blue Shield $17 - $139 13%
Blue Shield - Ca $17 - $139 13%
Cigna $17 - $121 13%
Healthnet $17 - $106 13%
Cba Network By Design $18 - $110 13%
Bcn Domestic $22 - $139 16%
Blue Benefit Administrators Of Massachusetts $22 - $139 16%
Blue Care Network $22 - $139 16%
Blue Distinction Transplant $22 - $139 16%
Blue Shield - Id (Regence) $22 - $139 16%
Blue Shield - Ny Highmark Northeastern $22 - $139 16%
Blue Shield - Ny Highmark Western $22 - $139 16%
Blue Shield - Pa (Highmark) $22 - $139 16%
Blue Shield - Wa (Regence) $22 - $139 16%
Health Choices $22 - $139 16%
Kaiser Domestic $22 - $139 16%
Pre-Employment $22 - $139 16%
Wc Domestic $22 - $139 16%
Kaiser Permanente $26 - $166 19%
Albany County Correctional Facility $30 - $93 22%
Ambetter / Centene $30 - $93 22%
Amish Mennonite $30 - $93 22%
Andrie Inc $30 - $93 22%
Ascension St. Vincent Public Safety Medical $30 - $93 22%
Bcccp-Michigan $30 - $93 22%
Bccp $30 - $93 22%
Bmc Healthnet $30 - $93 22%
Breast Grant-Connecticut $30 - $93 22%
Broward County Dept Of Health $30 - $93 22%
California Health And Wellness $30 - $93 22%
Can Community Health Inc $30 - $93 22%
Cardinal Innovations Lme $30 - $93 22%
Care Connections Of Northern Iowa $30 - $93 22%
Care Oregon Ohp $30 - $93 22%
Cencal Health Plan $30 - $93 22%
Cenpatico $30 - $93 22%
Chhuny $30 - $93 22%
Childrens Comm Health Plan $30 - $93 22%
Childrens Medical Services Title 19 $30 - $93 22%
City Of Philadelphia $30 - $93 22%
Cmh Allegan County $30 - $93 22%
Cmh Ausable Valley $30 - $93 22%
Cmh Barry County $30 - $93 22%
Cmh Bay-Arenac County $30 - $93 22%
Cmh Berrien County $30 - $93 22%
Cmh Cass County $30 - $93 22%
Cmh Central Mi County $30 - $93 22%
Cmh Clinton-Eaton-Ingham County $30 - $93 22%
Cmh Detroit Wayne Integrated Health Network $30 - $93 22%
Cmh Genesee County $30 - $93 22%
Cmh Ionia County $30 - $93 22%
Cmh Jackson County/Lifeways $30 - $93 22%
Cmh Kalamazoo $30 - $93 22%
Cmh Kent County $30 - $93 22%
Cmh Lenawee County $30 - $93 22%
Cmh Livingston County $30 - $93 22%
Cmh Macomb $30 - $93 22%
Cmh Misc $30 - $93 22%
Cmh Monroe County $30 - $93 22%
Cmh Montcalm County $30 - $93 22%
Cmh Muskegon County $30 - $93 22%
Cmh Newaygo County $30 - $93 22%
Cmh North Country $30 - $93 22%
Cmh Northern Lakes County $30 - $93 22%
Cmh Oakland County $30 - $93 22%
Cmh Ottawa County $30 - $93 22%
Cmh Van Buren County $30 - $93 22%
Cmh Washtenaw County $30 - $93 22%
Cmh Wayne County/Carelink $30 - $93 22%
Cmh Wayne Cty/Com Liv Svcs $30 - $93 22%
Cmh West Mi County $30 - $93 22%
Community Benefit Health $30 - $93 22%
Community Care Behavorial Health $30 - $93 22%
Community Care Partners $30 - $93 22%
Community Health Choice $30 - $93 22%
Connections Csp $30 - $93 22%
County Coroner $30 - $93 22%
County Funding Generic $30 - $93 22%
Covid19 Hrsa Uninsured Testing And Treatment Fund $30 - $93 22%
Dean Wi Badgercare $30 - $93 22%
Delaware County Department Of Health $30 - $93 22%
Delaware First Health $30 - $93 22%
Delta Dental Nj $30 - $93 22%
Dph Tb Program $30 - $93 22%
Dscc $30 - $93 22%
East Greenbush Central School District $30 - $93 22%
Eastpointe Lme $30 - $93 22%
Family Health Network $30 - $93 22%
Freedom First Healthcare $30 - $93 22%
Fresno County Ccs $30 - $93 22%
Genex Wc $30 - $93 22%
Ghc Scw Wi Badgercare $30 - $93 22%
Harbor Health $30 - $93 22%
Health Safety Net $30 - $93 22%
Healthsmart Workers Comp $30 - $93 22%
Healthy Blue Ne $30 - $93 22%
Hennepin Health $30 - $93 22%
Id County Ada $30 - $93 22%
Id County Canyon $30 - $93 22%
Id County Cat Fund $30 - $93 22%
Id County Other $30 - $93 22%
Id County Payette $30 - $93 22%
Idaho Dept Health And Wellfare $30 - $93 22%
Idaho Womens Health Check $30 - $93 22%
Indiana Breast Cervical Cancer $30 - $93 22%
Inland Empire Health Plan $30 - $93 22%
Intercommunity Health Ohp $30 - $93 22%
Iowa Total Care $30 - $93 22%
Jag Source $30 - $93 22%
Jai Medical System $30 - $93 22%
Kern Family Health Plan $30 - $93 22%
Keystone First $30 - $93 22%
Keystone First Chip $30 - $93 22%
La Care Health Plan $30 - $93 22%
Lakeland Care Inc $30 - $93 22%
Managed Health Services - Indiana $30 - $93 22%
Maryland Breast & Cervical Program $30 - $93 22%
Maryland Healthy Smiles - Scion Dental $30 - $93 22%
Maryland Physicians Care $30 - $93 22%
Massachusetts Behavioral Health Partnership $30 - $93 22%
Mdwise $30 - $93 22%
Medi-Cal $30 - $93 22%
Medi-Cal Healthnet $30 - $116 22%
Medstar Dc Healthy Family $30 - $93 22%
Medstar Md Health Choice $30 - $93 22%
Mo Home State Health Plan $30 - $93 22%
Molina Centennial Care $30 - $93 22%
Nascentia Health Options $30 - $93 22%
Nebraska Total Care $30 - $93 22%
New York Cancer Services Program $30 - $93 22%
New York State Insurance Fund $30 - $93 22%
Nextlevel Health $30 - $93 22%
Njm Insurance Group $30 - $93 22%
Oregon Screenwise $30 - $93 22%
Pace Of Southwest Michigan $30 - $93 22%
Paramount Advantage $30 - $93 22%
Parkland Community Health Plan $30 - $93 22%
Partners Behavioral Lme $30 - $93 22%
Peach State Healthplan $30 - $93 22%
Philadelphia County Funding $30 - $93 22%
Presbyterian Centennial Care $30 - $93 22%
Prestige Health Choice $30 - $93 22%
Priority Partners $30 - $93 22%
Robert F Sing Program $30 - $93 22%
Rx 340B Pass Along $30 - $93 22%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $30 - $93 22%
Rx Heatlhcomp $30 - $93 22%
Rx Medi-Cal $30 - $93 22%
Rx Meridian Rx $30 - $93 22%
Rx Restat $30 - $93 22%
Rx Saif Opdp Wc $30 - $93 22%
Rx Worker'S Comp $30 - $93 22%
Ryan White Florida Mssrp $30 - $93 22%
Sandhills Center Lme $30 - $93 22%
Screening For Life $30 - $93 22%
St Joseph County Hlth Dpt $30 - $93 22%
Stephenson Cty Health $30 - $93 22%
Sunshine State Health Plan $30 - $93 22%
Superior Health $30 - $93 22%
Tenncare $30 - $93 22%
Texas Children'S Health Plan $30 - $93 22%
Trillium Community Ohp $30 - $93 22%
Tufts Health Public Plans $30 - $93 22%
Vaya Health Lme $30 - $93 22%
Washtenaw Health Plan $30 - $93 22%
Wc Accident Fund $30 - $93 22%
Wc Ace $30 - $93 22%
Wc Acs Federal Employees $30 - $93 22%
Wc Acuity $30 - $93 22%
Wc Advantage $30 - $93 22%
Wc Aegis $30 - $93 22%
Wc Aig $30 - $93 22%
Wc Aims $30 - $93 22%
Wc Alaska National Ins $30 - $93 22%
Wc Align Network $30 - $93 22%
Wc Allied $30 - $93 22%
Wc Am Trust N America $30 - $93 22%
Wc American Claims Mgmt $30 - $93 22%
Wc Amerisure $30 - $93 22%
Wc Amtrust $30 - $93 22%
Wc Asu Risk Mgt $30 - $93 22%
Wc Benetech $30 - $93 22%
Wc Berkley Admin $30 - $93 22%
Wc Broadspire $30 - $93 22%
Wc Broward County $30 - $93 22%
Wc Bunch & Associates $30 - $93 22%
Wc California State Comp Ins $30 - $93 22%
Wc California State Ins Fund $30 - $93 22%
Wc Capitol Area Health Consortium $30 - $93 22%
Wc Ccmsi $30 - $93 22%
Wc Chartis $30 - $93 22%
Wc Chubb $30 - $93 22%
Wc Cirma $30 - $93 22%
Wc City Of Albany $30 - $93 22%
Wc City Of Sioux City $30 - $93 22%
Wc Claims Mgmt Inc $30 - $93 22%
Wc Cna $30 - $93 22%
Wc Comp One Admin C/O Manageability $30 - $93 22%
Wc Compone Admin $30 - $93 22%
Wc Corvel $30 - $249 22%
Wc Ct Healthcare Trust $30 - $93 22%
Wc Donegal Insurance Group $30 - $93 22%
Wc Emc Insurance Company $30 - $93 22%
Wc Employee Mutual $30 - $93 22%
Wc Enablecomp $30 - $93 22%
Wc Encore Health Network $30 - $93 22%
Wc Erie $30 - $93 22%
Wc Esis $30 - $93 22%
Wc Evolutions $30 - $93 22%
Wc Fcci $30 - $93 22%
Wc Fed Ex $30 - $93 22%
Wc Federal Black Lung $30 - $93 22%
Wc Federated $30 - $93 22%
Wc Finley Occupational Health $30 - $93 22%
Wc First Agency/Occunet $30 - $93 22%
Wc Ford Motor $30 - $93 22%
Wc Fresno Unified Emp $30 - $93 22%
Wc Gallagher Bassett $30 - $93 22%
Wc General Motors $30 - $93 22%
Wc Generic $30 - $93 22%
Wc Genex Care For Ohio $30 - $93 22%
Wc Great West Casualty $30 - $93 22%
Wc Guarantee Insurance $30 - $93 22%
Wc Guard Insurance Company $30 - $93 22%
Wc Hab $30 - $93 22%
Wc Hartford $30 - $93 22%
Wc Hastings $30 - $93 22%
Wc Health Management $30 - $93 22%
Wc Heritage Summit $30 - $93 22%
Wc Hireright $30 - $93 22%
Wc Horizon $30 - $93 22%
Wc Icw Group $30 - $93 22%
Wc Idaho State Ins Fund $30 - $93 22%
Wc Intercare Insurance $30 - $93 22%
Wc Intermountain $30 - $93 22%
Wc Johns Eastern $30 - $93 22%
Wc Kemberton $30 - $93 22%
Wc Key Ins & Benefit Solutions $30 - $93 22%
Wc Liberty Mutual $30 - $93 22%
Wc Mac Risk Management $30 - $93 22%
Wc Massachusetts $30 - $93 22%
Wc Mdia $30 - $93 22%
Wc Meadowbrook Claim $30 - $93 22%
Wc Medical Administrators $30 - $93 22%
Wc Meijers $30 - $93 22%
Wc Memic $30 - $93 22%
Wc Mercy Workcare $30 - $93 22%
Wc Michigan $30 - $93 22%
Wc Michigan Millers Mutual $30 - $93 22%
Wc Mitchell Frankenmuth $30 - $93 22%
Wc Mra $30 - $93 22%
Wc Nationwide $30 - $93 22%
Wc Nca Comp $30 - $93 22%
Wc New York $30 - $93 22%
Wc New York Special Funds $30 - $93 22%
Wc North American Rishces $30 - $93 22%
Wc Northeast Health $30 - $93 22%
Wc Notre Dame $30 - $93 22%
Wc Novanet $30 - $93 22%
Wc O'Hara Corp $30 - $93 22%
Wc Occ Health Allen $30 - $93 22%
Wc Ohio Bureau $30 - $93 22%
Wc One Call Medical $30 - $93 22%
Wc Paradigm $30 - $93 22%
Wc Peerless $30 - $93 22%
Wc Pma $30 - $93 22%
Wc Praxis Health Network $30 - $93 22%
Wc Price Chopper $30 - $93 22%
Wc Procura Management $30 - $93 22%
Wc Qualcare $30 - $93 22%
Wc Quiktrip $30 - $93 22%
Wc Reny Company $30 - $93 22%
Wc Rev Claims $30 - $93 22%
Wc Risico $30 - $93 22%
Wc Rural Mutual $30 - $93 22%
Wc Saif Oregon $30 - $93 22%
Wc Secura $30 - $93 22%
Wc Sedgwick $30 - $93 22%
Wc Sentry $30 - $93 22%
Wc Sheakley Unicomp $30 - $93 22%
Wc Smile Lodge $30 - $93 22%
Wc Society $30 - $93 22%
Wc Srs $30 - $93 22%
Wc Taconic (Mro) $30 - $93 22%
Wc Taconic Farms $30 - $93 22%
Wc Travelers $30 - $93 22%
Wc Triad Group $30 - $93 22%
Wc Tristar $30 - $93 22%
Wc Troy Ny $30 - $93 22%
Wc Tyson $30 - $93 22%
Wc Unified Health Services $30 - $93 22%
Wc United Heartland $30 - $93 22%
Wc Us Dept Of Labor $30 - $93 22%
Wc Velocity $30 - $93 22%
Wc Walmart $30 - $93 22%
Wc West Bend $30 - $93 22%
Wc West Bend Mutual/Argent $30 - $93 22%
Wc Winnebago Industries $30 - $93 22%
Wc Yankee Trails $30 - $93 22%
Wc York Risk $30 - $93 22%
Wc Zenith $30 - $93 22%
Wc Zurich $30 - $93 22%
Wellsense Health Plan $30 - $93 22%
Wi Womens Wellness $30 - $93 22%
Advantek Central Usd $77 57%
Ally Align Care Adv $83 61%
American Health Advantage Of Idaho $83 61%
American Health Plan $83 61%
Aurora Special Needs $83 61%
Blue Care Network Advantage $83 61%
Blue Shield - De (Highmark) Medciare Advantage $83 61%
Care Dimensions $83 61%
Care Improvement Plus $83 61%
Care Resources Pace $83 61%
Careplus Health Plans $83 61%
Cca - Zing Health $83 61%
Cca Senior Care Options $83 61%
Central Valley Medical Services Corp Pace $83 61%
Champion Health Plan Mcr Advantage $83 61%
Clear Spring Health $83 61%
Clover Health $83 61%
Commonwealth Care Alliance $83 61%
Community Pace At Home $83 61%
Eddy Senior Care-Pace $83 61%
Eddy Seniorcare Pace $83 61%
Elementcare $83 61%
Evercare $83 61%
Everence $83 61%
Gateway Health Plan $83 61%
Genesys Pace Of Genesee County $83 61%
Georgia Health Advantage $83 61%
Gold Advantage $83 61%
Gpa Croell Redi Mix $83 61%
Health America Advantra $83 61%
Highmark Health Options Dual Plan $83 61%
Hope Select Pace $83 61%
Horizon Nj Total Care $83 61%
Hudson Headwaters Pace $83 61%
Huron Valley Pace $83 61%
Innovative Integrated Health Community Plans $83 61%
Iowa Health Advantage $83 61%
Johns Hopkins Advantage Md $83 61%
Lasso Healthcare Msa $83 61%
Life St Marys Pace $83 61%
Lifecircles Pace $83 61%
Longevity Health Plan $83 61%
Longevity Ipa Of Michigan Llc Health Plan Isnp $83 61%
Martins Point Generations Advantage $83 61%
Mass General Brigham Mcr Adv $83 61%
Medipak Advantage $83 61%
Mercy Life $83 61%
Mercyone Cedar Valley $83 61%
Meridian Complete $83 61%
Michigan Complete Health $83 61%
Nascentia Health Plus $83 61%
New Centry Health Careplus $83 61%
Osu Prime Care Advantage $83 61%
Pace Cny $83 61%
Pace Iowa Immanuel Pathways $83 61%
Pace Southeast $83 61%
Pace-Trinity Health $83 61%
Peak Pace Solutions $83 61%
Perennial Advantage $83 61%
Preferred Care Partners $83 61%
Presbyterian Senior Plan $83 61%
Provider Partners Health Plan Of Illinois $83 61%
Provider Partners Health Plan Of Indiana $83 61%
Pruitthealth Premier $83 61%
Reliance Community Care Partners Care Resources Pace $83 61%
Rx Allwin $83 61%
Rx Grane Grnmedd $83 61%
Rx Retiree Rx Care $83 61%
Scan Health Plan Mcr Ipa Meritage Oon $83 61%
Secure Horizons Ma Pffs $83 61%
Serenity Pace $83 61%
Siouxland Pace $83 61%
Solis Health Plans $83 61%
Sunnyview-Pace Finance Dept $83 61%
Texan Plus $83 61%
The Health Plan $83 61%
Thome Pace $83 61%
Todays Options $83 61%
Tribute Health Plans $83 61%
Um Health Advantage $83 61%
Union Health Service $83 61%
Wellmed $83 61%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals