CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: San Joaquin General Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $95
  • Cash Discount Price: $177
  • vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at San Joaquin General Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $177. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.70x the Medicare baseline. Located in 500 W Hospital Road, French Camp, CA.
Cash / Self-Pay
$177

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $177 (131%)
Insurance Median: $95 (70%)
Cash: $177 (131% of Medicare)
Ins. Median: $95 (70% 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
Hpsj $49 - $95 36%
Ca Health And Wellness $92 68%
Healthnet $92 - $270 68%
Aetna $95 70%
Blue Cross Blue Shield $95 70%
Blueshield $95 70%
Brand New Day $95 70%
Cigna $95 70%
Humana $95 70%
Sutter $95 70%
UnitedHealthcare $95 70%
Blue Shield $158 117%
Networks By Design $338 249%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 W Hospital Road, French Camp, CA 95231
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals