CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Ventura County Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $92
  • Cash Discount Price: $225
  • vs. Medicare Baseline: 0.78x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Ventura County Medical Center is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.78x the Medicare baseline. Located in 300 Hillmont Avenue, Ventura, CA.
Cash / Self-Pay
$225

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $225 (191%)
Insurance Median: $92 (78%)
Cash: $225 (191% of Medicare)
Ins. Median: $92 (78% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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
Medi-Cal $57 48%
Alignment Hp - All Plans $73 62%
Humana $73 62%
Ntwrk Provdrs-All Plans $73 62%
Scan-All Plans $73 62%
Gold Coast Medi-Cal-All Plans $77 65%
Cigna $81 69%
Imperial-All Plans $84 71%
Vchcp-All Plans $86 73%
Western Growers-All Plans $92 78%
UnitedHealthcare $97 83%
Healthnet Comm-All Other Plans $99 84%
Blue Cross Blue Shield $119 101%
Blue Shield Comm - All Other Plans $119 101%
Blue Shield Epn $119 101%
Clinicas Comm - All Other Plans $322 274%
Clinicas Mcal $322 274%
Clinicas Mcr Adv $322 274%
Healthnet Mcr Adv $338 287%
Multiplan/Claritev-All Plans $360 306%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Hillmont Avenue, Ventura, CA 93003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals