CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Adventist Health Tehachapi Valley

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $106
Cash Discount Price: $52
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Adventist Health Tehachapi Valley is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.90x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$106

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: $52 (44%)

Insurance Median: $106 (90%)

Cash: $52 (44% of Medicare)

Ins. Median: $106 (90% 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.

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
Medi-Cal	$57 - $82	48%
Universal Ipa Mcal Op/Profee Only	$57 - $82	48%
Aetna	$68 - $107	58%
Tricare	$72 - $304	61%
Network Providers- All Plans	$78 - $389	66%
Ah Employee Health Plan - All Plans	$79 - $119	67%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$80 - $304	68%
Kaiser Medi-Cal Ip/Op Only	$82	70%
Oscar Health Plan- All Plans	$82 - $115	70%
Bc Mcal	$85	72%
Coventry- All Plans	$86 - $202	73%
Cigna	$87 - $176	74%
Western Grwrs/Pinnacle - All Plans	$94 - $100	80%
Blue Shield Epn- All Other Plans	$95 - $154	81%
UnitedHealthcare	$97	83%
Healthnet Medi-Cal	$101	86%
Healthnet- All Other Plans	$104 - $173	88%
Khs-Kern Hlth Systm Mcal	$106	90%
Centivo - All Plans	$107 - $685	91%
Blue Shield Non-Epn	$112 - $163	95%
Klhp-Kern Legacy Epo -All Other Plans	$112	95%
Blue Cross Blue Shield	$130 - $202	111%
Healthnet Mcare	$304	259%
Medicare (plans)	$304	259%
Kaiser Ip/Op Only- All Other Plans	$523	445%

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 $52.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Tehachapi Valley is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
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.