CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Ventura County Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $101
  • Cash Discount Price: $225
  • vs. Medicare Baseline: 0.74x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Ventura County Medical Center is $101. 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 $135.6, this hospital’s rate is 0.74x 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
$101

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: $225 (166%)
Insurance Median: $101 (74%)
Cash: $225 (166% of Medicare)
Ins. Median: $101 (74% 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
Medi-Cal $38 28%
Gold Coast Medi-Cal-All Plans $51 38%
Vchcp-All Plans $86 63%
Alignment Hp - All Plans $87 64%
Humana $87 64%
Ntwrk Provdrs-All Plans $87 64%
Scan-All Plans $87 64%
Cigna $96 71%
Imperial-All Plans $100 74%
UnitedHealthcare $101 74%
Western Growers-All Plans $109 80%
Blue Shield Comm - All Other Plans $113 83%
Blue Shield Epn $113 83%
Blue Cross Blue Shield $116 86%
Healthnet Comm-All Other Plans $118 87%
Clinicas Comm - All Other Plans $322 237%
Clinicas Mcal $322 237%
Clinicas Mcr Adv $322 237%
Healthnet Mcr Adv $338 249%
Multiplan/Claritev-All Plans $360 265%

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