CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Adventist Health Delano

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $147
Cash Discount Price: $57
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Adventist Health Delano is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.08x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$57

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $57 (42%)

Insurance Median: $147 (108%)

Cash: $57 (42% of Medicare)

Ins. Median: $147 (108% 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.

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
Dignty Hlth Mcal Op Only	$54	40%
Kaiser Medi-Cal Ip/Op Only	$54	40%
Medi-Cal	$54	40%
Universal Care Mcal	$54	40%
Blue Shield Epn - All Other Plans	$63	46%
Healthnet Medi-Cal	$64	47%
Blue Cross Blue Shield	$69 - $238	51%
Kern Health System Mcal	$69 - $266	51%
Bakersfield Fam Med Grp-All Plans	$85	63%
Healthnet Mcr Adv	$85	63%
Kern Mcr Adv Dual Dnsp-All Other Plans	$85	63%
Medicare (plans)	$85 - $137	63%
Tricare	$85	63%
UnitedHealthcare	$85 - $206	63%
Universal Care Mcr- All Other Plans	$85	63%
Kaiser Comm Ip/Op Only- All Other Plans	$147	108%
Ah Employee Health Plan - All Plans	$154	114%
Coventry- All Plans	$172	127%
Blue Shield Non-Epn	$186	137%
Centivo - All Plans	$192	142%
Healthnet- All Other Plans	$192	142%
County Of Kern Network - All Plans	$200	147%
Gem Care- All Plans	$200	147%
Aetna	$211	156%
Foundation For Medical Care Of Kern County - All P	$214	158%
Cigna	$229	169%
Western Growers - All Plans	$232	171%

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 $57.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Delano is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
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.