CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Adventist Health Ukiah Valley

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $152
Cash Discount Price: $45
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Adventist Health Ukiah Valley is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.29x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$152

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: $45 (38%)

Insurance Median: $152 (129%)

Cash: $45 (38% of Medicare)

Ins. Median: $152 (129% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Kaiser Medi-Cal	$57 - $82	48%
Medi-Cal	$57 - $82	48%
Blue Cross Blue Shield	$66 - $188	56%
Blue Shield Mcr Adv	$71 - $280	60%
Kaiser Mcr Adv	$71 - $280	60%
Tricare	$71 - $280	60%
UnitedHealthcare	$71 - $293	60%
Aetna	$77 - $233	65%
Ah Employee Health Plan - All Plans	$78 - $505	66%
Blue Shield Epn-All Other Plans	$86 - $154	73%
Blue Shield Non-Epn	$87 - $163	74%
Cigna	$92 - $274	78%
Western Growers-All Plans	$102 - $128	87%
Healthnet-All Plans	$104 - $201	88%
Mendocino Lcc District-All Plans	$104 - $228	88%
Kaiser-All Other Plans	$128 - $281	109%
Three Rivers-All Plans	$144 - $316	122%
Foundation For Medical Care-All Plans	$169 - $263	144%
Networks By Design-All Plans	$180 - $281	153%
Phcs Multiplan-All Plans	$180 - $281	153%
Interplan-All Plans	$184 - $288	157%
Beech Street-All Plans	$191 - $298	162%
Choice Care-All Plans	$191 - $298	162%
Health Mgmt Network-All Plans	$191 - $298	162%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $45.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Ukiah Valley is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.