CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Tri-City Medical Center

Billing Code: 99203 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$98
about 0.8× the $118 Medicare rate · typically $58–$175
modeled estimate · not a bill or quote
What this hospital charges insurers
$80
Below the fair price — a good deal
about $18 under the fair price · 0.7× Medicare
Medicare pays $118 Fair price $98 This hospital $80 Cash price $214 Hospital's list price $357

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $34 Priciest $80

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

A fair price for a New patient office visit (30-44 min) is about $98 (about 0.8× the $118 Medicare rate). Tri-City Medical Center charges insurers about $80, or about $214 in cash — below the fair price — a good deal. Located in Oceanside, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $150 - $164 128%
Blue Cross Blue Shieldmajor $212 180%
Aetnamajor $71 - $250 60%
Cignamajor $264 - $282 225%
Kaiser Permanentemajor $125 106%
Health Net $58 - $278 49%
Molina $107 91%
Providence Health Plan $107 91%
+ 3 smaller / regional plans $89 - $214
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 4002 Vista Way, Oceanside, CA 92056
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals