CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Adventist Health White Memorial
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $88
- Cash Discount Price: $42
- vs. Medicare Baseline: 0.65x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Adventist Health White Memorial is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.65x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$42
Average discount available for prompt cash payment at this facility.
Insurance Median
$88
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: $42 (31%)
Insurance Median: $88 (65%)
Cash: $42 (31% of Medicare)
Ins. Median: $88 (65% 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.
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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 | $38 - $54 | 28% |
| Altamed Medi-Cal - All Other Plans | $38 - $62 | 28% |
| Bc Medi-Cal | $38 - $76 | 28% |
| Blue Shield Medi-Cal | $38 - $134 | 28% |
| Care First Medi-Cal | $38 - $188 | 28% |
| Healthcare Inc Medi-Cal | $38 - $54 | 28% |
| Lasalle Mg Medi-Cal | $38 - $54 | 28% |
| Medi-Cal | $38 - $54 | 28% |
| Pacific Alliance Medi-Cal | $38 - $54 | 28% |
| Pacific Ipa Medi-Cal | $38 - $54 | 28% |
| Preferred Medi-Cal | $38 - $54 | 28% |
| Fcs Ipa Medi-Cal Op/Profee Only | $45 - $65 | 33% |
| Healthnet Mcal | $45 - $64 | 33% |
| Ahp Medi-Cal | $52 - $54 | 38% |
| Assoc Hispanic Physcns Mcal | $52 - $75 | 38% |
| Bella Vista Medi-Cal Op/Profee Only | $52 - $54 | 38% |
| El Proyecto Mcal Profee Only | $52 | 38% |
| Global Care Mcal Profee Only | $52 | 38% |
| Hcla Mcal Profee Only | $52 | 38% |
| Alta Los Angeles Mcal 1/1/19 | $54 | 40% |
| Avanti Mcal | $54 | 40% |
| Molina Medi-Cal | $54 - $60 | 40% |
| Preferred Ipa La Care Mcal Cap | $54 | 40% |
| Blue Shield Epn | $56 - $156 | 41% |
| Prospect Mg Com/Pos Profee Only-All Other Plan | $60 - $90 | 44% |
| Prospect Mg Mcal Profee Only | $60 - $90 | 44% |
| Prospect Mg Mcr Adv Profee Only | $60 - $90 | 44% |
| Blue Shield - All Other Plans | $65 - $165 | 48% |
| Preferred Healthy | $67 | 49% |
| Blue Shield Mcr Adv | $71 - $109 | 52% |
| Aetna | $74 - $115 | 55% |
| Access Group | $75 | 55% |
| Ahp - All Other Plans | $75 - $88 | 55% |
| Lasalle Mg Commercial - All Other Plans | $75 | 55% |
| Blue Cross Blue Shield | $82 - $158 | 60% |
| Access Senior - All Other Plans | $88 | 65% |
| Ahp Senior | $88 | 65% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $88 | 65% |
| Altamed Connect | $88 | 65% |
| Avanti Mcr Adv - All Other Plans | $88 | 65% |
| Brand New Day Mcare - All Plans | $88 | 65% |
| Bs Va Mcare | $88 | 65% |
| Care First Mcare - All Other Plans | $88 | 65% |
| Clever Care - All Plans | $88 | 65% |
| El Proyecto Comm Profee Only - All Other Plans | $88 | 65% |
| Fcs Ipa Mcr Advan Op/Profee Only | $88 | 65% |
| Global Care Comm Profee Only - All Other Plans | $88 | 65% |
| Hcla Comm Profee Only - All Other Plans | $88 | 65% |
| Humana | $88 | 65% |
| Lasalle Mg Senior | $88 | 65% |
| Medicare (plans) | $88 | 65% |
| Molina Mcare | $88 - $150 | 65% |
| Pacific Alliance Mcare - All Other Plans | $88 | 65% |
| Preferred Senior | $88 | 65% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $88 | 65% |
| Tricare | $88 | 65% |
| UnitedHealthcare | $88 - $118 | 65% |
| Pacific Ipa - All Other Plans | $90 | 66% |
| Cigna | $93 - $100 | 69% |
| Fcs Ipa Op/Profee Only - All Other Plans | $93 | 69% |
| Ah Employee Health Plan - All Plans | $97 - $159 | 72% |
| Kaiser- All Plans | $97 | 72% |
| Molina Benefit Exchange - All Other Plans | $100 - $150 | 74% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $106 | 78% |
| Preferred Commercial - All Other Plans | $106 | 78% |
| Healthnet - All Other Plans | $107 - $129 | 79% |
| Healthnet Comm Care | $110 - $129 | 81% |
| Intergrated Medical - All Plans | $115 | 85% |
| Caremore Mcare - All Plans | $118 | 87% |
| Hcpamg - All Plans | $118 | 87% |
| Western Growers/Pinnacle - All Plans | $123 - $175 | 91% |
| Healthcare Inc - All Other Plans | $130 | 96% |
| La Care Mcr Adv - All Plans | $130 | 96% |
| Centivo - All Plans | $133 - $199 | 98% |
| Php-Prospect Health Plan Cap - All Plans | $133 | 98% |
| First Heatlh Ppo - All Plans | $137 | 101% |
| Phcs Ppo - All Plans | $153 | 113% |
| Scan Health Mcare - All Plans | $153 | 113% |
| Multiplan Ppo - All Plans | $166 - $249 | 122% |
| Ahf - All Plans | $177 | 131% |
| Beech Street - All Plans | $177 | 131% |
| Interplan Ppo - All Plans | $177 | 131% |
| Corvel Corp - All Plans | $189 | 139% |
| Healthmannet - All Plans | $201 | 148% |
| Next Inc Ppo - All Plans | $201 | 148% |
| Trpn - All Plans | $201 | 148% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $212 | 156% |
| Fpn Ppo - All Plans | $212 | 156% |
| Healthnet Mcr Adv | $361 | 266% |
| Bright Health - All Plans | $1,850 | 1364% |