CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Adventist Health Bakersfield

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $108
  • Cash Discount Price: $20
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Adventist Health Bakersfield is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $20. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.13x the Medicare baseline. Located in 2615 Chester Avenue, Bakersfield, CA.
Cash / Self-Pay
$20

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$95.19

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $95.19 (100%)
Cash / Self-Pay: $20 (21%)
Insurance Median: $108 (113%)
Cash: $20 (21% of Medicare)
Ins. Median: $108 (113% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $95.19 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
Bc Medi-Cal $24 - $44 25%
Medi-Cal $24 - $34 25%
Universal Hc Mcal Profee Only $24 25%
Kaiser Mcal Ip/Op Only $34 36%
Kern Health Systems Mcal $34 - $266 36%
Healthnet Mcal $41 43%
Aetna $45 - $205 47%
Blue Shield Mcr Adv $58 61%
Fhcn Pace Mcr Adv - All Plans $58 61%
Gem Care- All Plans $58 - $207 61%
Healthnet Mcr Adv $58 61%
Kaiser Mcr Adv Ip/Op Only $58 61%
Kern Legacy Share Select $58 - $207 61%
Oscar - All Plans $58 - $93 61%
Premier Physician Alliance Profee Only-All Plans $58 61%
UnitedHealthcare $58 - $180 61%
Universal Health Plan Mcare-All Other Plans $58 61%
Cigna $64 - $215 67%
County Of Kern - All Plans $64 - $207 67%
Employee Health Plan - All Plans $64 - $105 67%
Kern Legacy Hp Epo - All Other Plans $64 - $207 67%
Amrcn Indian Hlth Proj Mcr Adv - All Plans $70 74%
Network Provdrs Llc Mcare -All Payers $76 80%
Western Growers/Pinnacle- All Plans $81 - $294 85%
Healthnet Hmo/Pos/Ppo/Epo - All Other Plans $85 - $308 89%
Centivo - All Plans $87 - $131 91%
Kaiser Comm Hmo Ip/Op Only-All Other Plans $100 105%
Blue Shield Epn $108 - $137 113%
Blue Cross Blue Shield $112 - $253 118%
Blue Shield Epo/Ppo $114 - $153 120%
Blue Shield Hmo/Pos - All Other Plans $114 - $153 120%
First Health/Coventry- All Plans $248 261%
Phcs- All Plans $269 283%
Interplan- All Plans $290 305%
Affiliated Health Funds-All Plans $331 348%
Integrated Health Plan-All Plans $331 348%
Three Rivers Provider Network- All Plans $331 348%
Beech Street- All Plans $352 370%
Galaxy Health Network- All Plans $373 392%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2615 Chester Avenue, Bakersfield, CA 93301
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals