CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Casa Colina Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $74
  • Cash Discount Price: $96
  • vs. Medicare Baseline: 0.63x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Casa Colina Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.63x the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.
Cash / Self-Pay
$96

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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: $96 (82%)
Insurance Median: $74 (63%)
Cash: $96 (82% of Medicare)
Ins. Median: $74 (63% 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.

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
Heritage Prvdr Ntwrk Comm - All Other Plans $26 22%
Heritage Prvdr Ntwrk Mcr $26 22%
Corvel - All Plans $32 27%
Coventry - All Plans $32 27%
Humana $32 - $74 27%
Multiplan - All Plans $32 27%
Three Rivers - All Plans $32 27%
UnitedHealthcare $32 - $74 27%
Cigna $36 31%
Blue Cross Blue Shield $38 - $74 32%
Brand New Day Mcr Adv - All Plans $39 33%
Blue Shield Comm - All Other Plans $48 41%
Healthcare Partners - All Other Plans $52 44%
Healthcare Partners Mcr $52 44%
Primecare Comm - All Other Plans $52 44%
Primecare Mcr Adv $52 44%
Heritage Prvdr Ntwrk Mcal $59 50%
Iehp Mcal $65 55%
Kaiser Mcal $65 55%
Medi-Cal $65 55%
Prospect Hp Mcal $67 57%
Promed Hlth Ntwrk Op Only - All Plans $70 60%
Aetna $74 - $181 63%
Blue Shield Mcr Adv $74 63%
Caremore Mcr Adv - All Plans $74 63%
Central Hlth Plan - All Plans $74 63%
Doctors Managed Op Only - All Plans $74 63%
Empire Healthcare Op Only - All Plans $74 63%
Epic Comm - All Other Plans $74 63%
Epic Mcr Adv $74 63%
Focus Healthcare Wc - All Plans $74 63%
Healthnet Mcr Adv $74 63%
Iehp - All Other Plans $74 63%
Iehp Mcr Adv $74 63%
Kaiser Comm - All Other Plans $74 63%
Kaiser Mcr Adv $74 63%
Premiercare Op Only - All Plans $74 63%
Prospect Hp Mcr Adv $74 63%
Triwest - All Plans $74 63%
Wellcare Mcr Adv - All Plans $74 63%
Prospect Hp Comm - All Other Plans $82 70%
Affiliated Hlth Funds - All Plans $93 79%
Healthnet Comm - All Other Plans $149 127%
Galaxy Provdr Ntwrk - All Plans $254 216%
Prospect Med Grp Alta - All Plans $308 262%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 E Bonita Ave, Pomona, CA 91767
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals