CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Adventist Health White Memorial
Billing Code: 99213 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99213
- Insurance Median: $60
- Cash Discount Price: $37
- vs. Medicare Baseline: 0.63x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Adventist Health White Memorial is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.63x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$37
Average discount available for prompt cash payment at this facility.
Insurance Median
$60
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$95.19
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $95.19 (100%)
Cash / Self-Pay: $37 (39%)
Insurance Median: $60 (63%)
Cash: $37 (39% of Medicare)
Ins. Median: $60 (63% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $95.19 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 |
|---|---|---|
| Access Medi-Cal | $24 - $34 | 25% |
| Altamed Medi-Cal - All Other Plans | $24 - $40 | 25% |
| Bc Medi-Cal | $24 - $49 | 25% |
| Blue Shield Medi-Cal | $24 - $86 | 25% |
| Care First Medi-Cal | $24 - $120 | 25% |
| Healthcare Inc Medi-Cal | $24 - $34 | 25% |
| Lasalle Mg Medi-Cal | $24 - $34 | 25% |
| Medi-Cal | $24 - $34 | 25% |
| Pacific Alliance Medi-Cal | $24 - $34 | 25% |
| Pacific Ipa Medi-Cal | $24 - $34 | 25% |
| Preferred Medi-Cal | $24 - $34 | 25% |
| Fcs Ipa Medi-Cal Op/Profee Only | $29 - $41 | 30% |
| Healthnet Mcal | $29 - $41 | 30% |
| Ahp Medi-Cal | $34 | 36% |
| Alta Los Angeles Mcal 1/1/19 | $34 | 36% |
| Assoc Hispanic Physcns Mcal | $34 - $48 | 36% |
| Avanti Mcal | $34 | 36% |
| Bella Vista Medi-Cal Op/Profee Only | $34 | 36% |
| El Proyecto Mcal Profee Only | $34 | 36% |
| Global Care Mcal Profee Only | $34 | 36% |
| Hcla Mcal Profee Only | $34 | 36% |
| Molina Medi-Cal | $34 - $38 | 36% |
| Preferred Ipa La Care Mcal Cap | $34 | 36% |
| Prospect Mg Com/Pos Profee Only-All Other Plan | $41 - $61 | 43% |
| Prospect Mg Mcal Profee Only | $41 - $61 | 43% |
| Prospect Mg Mcr Adv Profee Only | $41 - $61 | 43% |
| Preferred Healthy | $43 | 45% |
| Aetna | $48 - $100 | 50% |
| Blue Shield Epn | $49 - $115 | 51% |
| Access Group | $51 | 54% |
| Ahp - All Other Plans | $51 - $60 | 54% |
| Lasalle Mg Commercial - All Other Plans | $51 | 54% |
| Blue Shield - All Other Plans | $57 - $122 | 60% |
| UnitedHealthcare | $58 - $102 | 61% |
| Access Senior - All Other Plans | $60 | 63% |
| Ahp Senior | $60 | 63% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $60 | 63% |
| Altamed Connect | $60 | 63% |
| Avanti Mcr Adv - All Other Plans | $60 | 63% |
| Brand New Day Mcare - All Plans | $60 | 63% |
| Bs Va Mcare | $60 | 63% |
| Care First Mcare - All Other Plans | $60 | 63% |
| Cigna | $60 - $87 | 63% |
| Clever Care - All Plans | $60 | 63% |
| El Proyecto Comm Profee Only - All Other Plans | $60 | 63% |
| Fcs Ipa Mcr Advan Op/Profee Only | $60 | 63% |
| Global Care Comm Profee Only - All Other Plans | $60 | 63% |
| Hcla Comm Profee Only - All Other Plans | $60 | 63% |
| Humana | $60 | 63% |
| Lasalle Mg Senior | $60 | 63% |
| Medicare (plans) | $60 | 63% |
| Molina Mcare | $60 - $102 | 63% |
| Pacific Alliance Mcare - All Other Plans | $60 | 63% |
| Preferred Senior | $60 | 63% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $60 | 63% |
| Tricare | $60 | 63% |
| Blue Shield Mcr Adv | $62 - $81 | 65% |
| Blue Cross Blue Shield | $63 - $113 | 66% |
| Fcs Ipa Op/Profee Only - All Other Plans | $63 | 66% |
| Ah Employee Health Plan - All Plans | $66 - $108 | 69% |
| Molina Benefit Exchange - All Other Plans | $68 - $102 | 71% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $72 | 76% |
| Preferred Commercial - All Other Plans | $72 | 76% |
| Intergrated Medical - All Plans | $78 | 82% |
| Pacific Ipa - All Other Plans | $78 | 82% |
| Kaiser- All Plans | $84 | 88% |
| Western Growers/Pinnacle - All Plans | $84 - $152 | 88% |
| Healthnet - All Other Plans | $88 - $93 | 92% |
| Healthnet Comm Care | $88 - $96 | 92% |
| Centivo - All Plans | $90 - $136 | 95% |
| Php-Prospect Health Plan Cap - All Plans | $90 | 95% |
| Caremore Mcare - All Plans | $102 | 107% |
| Hcpamg - All Plans | $103 | 108% |
| Healthcare Inc - All Other Plans | $113 | 119% |
| La Care Mcr Adv - All Plans | $113 | 119% |
| Multiplan Ppo - All Plans | $113 - $170 | 119% |
| First Heatlh Ppo - All Plans | $119 | 125% |
| Phcs Ppo - All Plans | $133 | 140% |
| Scan Health Mcare - All Plans | $133 | 140% |
| Ahf - All Plans | $154 | 162% |
| Beech Street - All Plans | $154 | 162% |
| Interplan Ppo - All Plans | $154 | 162% |
| Corvel Corp - All Plans | $164 | 172% |
| Healthmannet - All Plans | $174 | 183% |
| Next Inc Ppo - All Plans | $174 | 183% |
| Trpn - All Plans | $174 | 183% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $184 | 193% |
| Fpn Ppo - All Plans | $184 | 193% |
| Healthnet Mcr Adv | $314 | 330% |
| Bright Health - All Plans | $1,850 | 1943% |