CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: UCSF Health St. Mary's Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $140
  • Cash Discount Price: $200
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at UCSF Health St. Mary's Hospital is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.03x the Medicare baseline. Located in 450 Stanyan St, San Francisco, CA.
Cash / Self-Pay
$200

Average discount available for prompt cash payment at this facility.

Insurance Median
$140

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: $200 (147%)
Insurance Median: $140 (103%)
Cash: $200 (147% of Medicare)
Ins. Median: $140 (103% 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
Sfhp $52 38%
Blue Cross Blue Shield $67 - $200 49%
California Health & Wellness $67 49%
Health Plan San Mateo $67 49%
Kaiser $67 - $152 49%
Partnership Health Plan $67 49%
Health Net $98 72%
Magellan $120 88%
Blue Shield Ca $139 - $194 103%
Healthsmart $140 103%
Brown Toland $153 113%
Multiplan $166 122%
Chinese Community $167 123%
United $200 147%
Us Behavioral Health $200 147%
Cigna $206 - $219 152%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Stanyan St, San Francisco, CA 94117
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals