CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $205
- Cash Discount Price: $506
- vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at AHMC Anaheim Regional Medical Center is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $506. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.51x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$506
Average discount available for prompt cash payment at this facility.
Insurance Median
$205
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: $506 (373%)
Insurance Median: $205 (151%)
Cash: $506 (373% of Medicare)
Ins. Median: $205 (151% 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 |
|---|---|---|
| Allied Physicians | $30 | 22% |
| Applecare Medical Group | $30 | 22% |
| Heritage Provider Network | $30 - $51 | 22% |
| Msi/Medical Services For Indigents | $30 - $52 | 22% |
| Non Contracted Medi-Cal | $30 | 22% |
| Talbert Medical Group | $30 - $85 | 22% |
| Blue Cross Blue Shield | $31 - $107 | 23% |
| Ahmc Reciprocity Agreement | $38 - $172 | 28% |
| Altamed Health Network | $38 | 28% |
| Beverly Hospital | $38 | 28% |
| Brand New Day | $38 - $345 | 28% |
| Health Net | $38 | 28% |
| Healthcare Partners | $38 | 28% |
| Healthy Way La | $38 | 28% |
| Netcare Life And Health Insurance | $41 - $144 | 30% |
| Caloptima | $42 - $54 | 31% |
| Monarch Health Plan | $42 - $575 | 31% |
| Aids Health Foundation | $43 | 32% |
| Avanti | $43 | 32% |
| Emanate Health | $43 | 32% |
| Health Net Inc | $43 - $442 | 32% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $43 | 32% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $43 | 32% |
| Hollywood Presbyterian Medpoint Mcal | $43 | 32% |
| Medi-Cal | $43 | 32% |
| Advance Clinical Research Institute | $50 - $172 | 37% |
| Memorial Healthcare Ipa | $50 - $172 | 37% |
| Prospect Health Plan | $52 | 38% |
| Kaiser Foundation Hospitals | $54 | 40% |
| Medical Safety Net Program | $54 | 40% |
| Medical Acquisition Company | $66 - $230 | 49% |
| Affiliated Doctors Of Orange County | $74 - $259 | 55% |
| Angels Baseball Workers Comp | $76 | 56% |
| Interplan | $81 - $402 | 60% |
| Medicare (plans) | $82 - $288 | 60% |
| Monarch Healthcare Medical Group | $82 | 60% |
| UnitedHealthcare | $82 - $288 | 60% |
| Cigna | $84 - $293 | 62% |
| Aetna | $86 - $299 | 63% |
| First Health | $87 - $489 | 64% |
| Orange County Preferred Provider Organization | $87 - $431 | 64% |
| Davita Heatlhcare Partners Plan Inc | $89 - $310 | 66% |
| Healthcare Partners Commercial | $89 - $310 | 66% |
| Huntington Memorial Hospital | $89 - $310 | 66% |
| Athens Administrators | $90 | 66% |
| Capp Care | $90 - $431 | 66% |
| Corvel | $90 - $431 | 66% |
| Marriot Intl | $90 | 66% |
| Non Contracted Workers Comp | $90 | 66% |
| Prospect Medical Group | $90 | 66% |
| Genesis Healthcare Ipa Ancillary | $99 - $345 | 73% |
| Scan Health Plan | $107 - $374 | 79% |
| Affiliated Health Fund | $116 - $402 | 86% |
| Allnet Preferred Provider | $116 - $402 | 86% |
| Care First | $116 - $402 | 86% |
| Private Healthcare Systems | $116 - $402 | 86% |
| Choicecare | $124 - $431 | 91% |
| Multiplan Inc | $124 - $431 | 91% |
| Blue Shield Of California | $129 - $454 | 95% |
| National Provider Network | $132 - $460 | 97% |
| Three Rivers Providers Network | $132 - $460 | 97% |
| Health Payors Organization | $148 - $518 | 109% |
| Non Contracted Commercial | $165 - $575 | 122% |
| Tricare | $165 - $575 | 122% |