CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Adventist Health Reedley

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $99
  • Cash Discount Price: $37
  • vs. Medicare Baseline: 0.84x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Adventist Health Reedley is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.84x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.
Cash / Self-Pay
$37

Average discount available for prompt cash payment at this facility.

Insurance Median
$99

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: $37 (31%)
Insurance Median: $99 (84%)
Cash: $37 (31% of Medicare)
Ins. Median: $99 (84% 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
Healthnet Medi-Cal $34 29%
Upn Mcr Adv Profee Only $48 41%
Bc Mcal $57 - $121 48%
Cal Viva Hlth Mcal - All Plans $57 - $82 48%
Central Ca Alliance Mcal Profee Only $57 48%
Dignity Mcal Op/Profee Only-All Other Plans $57 - $90 48%
Medi-Cal $57 - $82 48%
Upn Mcal Profee Only-All Other Plans $57 48%
Lasalle Med Assoc Profee Only - All Plans $71 60%
Tricare $71 - $375 60%
Aetna $72 - $619 61%
Kern Health Systems Mcal-All Plans $72 - $82 61%
Ah Employee Health Plan - All Plans $78 - $676 66%
Community Care Ipa Mcal-All Plans $85 - $107 72%
Central Ca Alliance Ccs Profee Only $86 73%
Central Ca Alliance Comm Profee Only - All Other P $86 73%
Cigna $87 - $146 74%
Blue Cross Blue Shield $94 - $183 80%
Kaiser - All Other Plans $96 - $112 82%
UnitedHealthcare $97 83%
Healthnet- All Other Plans $98 - $104 83%
Western Growers/Pinnacle- All Plans $99 - $104 84%
Central Ca Alliance Chdp Profee Only $114 97%
Blue Shield Epn - All Other Plans $122 - $147 104%
Physicians Med Group Op/Profee Only- All Plans $128 - $180 109%
Blue Shield Non Epn $141 - $155 120%
Blue Shield Mcare $375 319%
Dignity Mcr Adv Op/Profee Only $375 319%
Fhcn Pace Mcr Adv-All Plans $375 319%
Healthnet- Mcr Adv $375 319%
Kaiser Mcr Adv $375 319%
Phs Prime Health Srvcs $375 319%
Bright Health Mcr Adv - All Plans $589 501%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 372 W Cypress Ave, Reedley, CA 93654
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals