CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Casa Colina Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $88
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 0.65x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Casa Colina Hospital is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.65x the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$88

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: $115 (85%)
Insurance Median: $88 (65%)
Cash: $115 (85% of Medicare)
Ins. Median: $88 (65% 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
Medi-Cal $54 40%
Kaiser Mcal $59 44%
Heritage Prvdr Ntwrk Comm - All Other Plans $67 49%
Heritage Prvdr Ntwrk Mcr $67 49%
Healthnet Comm - All Other Plans $69 51%
Heritage Prvdr Ntwrk Mcal $71 52%
Prospect Hp Mcal $80 59%
Corvel - All Plans $84 62%
Coventry - All Plans $84 62%
Humana $84 - $88 62%
Multiplan - All Plans $84 62%
Promed Hlth Ntwrk Op Only - All Plans $84 62%
UnitedHealthcare $84 - $88 62%
Aetna $88 - $181 65%
Blue Cross Blue Shield $88 - $98 65%
Blue Shield Mcr Adv $88 65%
Caremore Mcr Adv - All Plans $88 65%
Central Hlth Plan - All Plans $88 65%
Doctors Managed Op Only - All Plans $88 65%
Empire Healthcare Op Only - All Plans $88 65%
Epic Comm - All Other Plans $88 65%
Epic Mcr Adv $88 65%
Focus Healthcare Wc - All Plans $88 65%
Healthnet Mcr Adv $88 65%
Iehp - All Other Plans $88 65%
Iehp Mcr Adv $88 65%
Kaiser Comm - All Other Plans $88 65%
Kaiser Mcr Adv $88 65%
Premiercare Op Only - All Plans $88 65%
Prospect Hp Mcr Adv $88 65%
Triwest - All Plans $88 65%
Wellcare Mcr Adv - All Plans $88 65%
Cigna $94 69%
Prospect Hp Comm - All Other Plans $97 72%
Affiliated Hlth Funds - All Plans $111 82%
Iehp Mcal $134 99%
Primecare Mcr Adv $134 99%
Prospect Med Grp Alta - All Plans $143 105%
Three Rivers - All Plans $181 133%
Brand New Day Mcr Adv - All Plans $218 161%
Galaxy Provdr Ntwrk - All Plans $254 187%
Blue Shield Comm - All Other Plans $268 198%
Healthcare Partners - All Other Plans $290 214%
Healthcare Partners Mcr $290 214%
Primecare Comm - All Other Plans $290 214%

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