CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Adventist Health Tehachapi Valley

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $123
Cash Discount Price: $61
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Adventist Health Tehachapi Valley is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.91x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$61

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $61 (45%)

Insurance Median: $123 (91%)

Cash: $61 (45% of Medicare)

Ins. Median: $123 (91% 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
Medi-Cal	$38 - $54	28%
Universal Ipa Mcal Op/Profee Only	$38 - $54	28%
Kaiser Medi-Cal Ip/Op Only	$54	40%
Bc Mcal	$55	41%
Healthnet Medi-Cal	$66	49%
Khs-Kern Hlth Systm Mcal	$69	51%
Aetna	$70 - $123	52%
Tricare	$85 - $304	63%
Cigna	$89 - $202	66%
Network Providers- All Plans	$93 - $389	69%
Ah Employee Health Plan - All Plans	$94 - $137	69%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$95 - $304	70%
Oscar Health Plan- All Plans	$98 - $137	72%
Coventry- All Plans	$102 - $233	75%
UnitedHealthcare	$102	75%
Western Grwrs/Pinnacle - All Plans	$109 - $119	80%
Blue Shield Epn- All Other Plans	$110 - $148	81%
Healthnet- All Other Plans	$124 - $199	91%
Centivo - All Plans	$128 - $685	94%
Blue Shield Non-Epn	$130 - $157	96%
Klhp-Kern Legacy Epo -All Other Plans	$130	96%
Blue Cross Blue Shield	$149 - $157	110%
Healthnet Mcare	$304	224%
Medicare (plans)	$304	224%
Kaiser Ip/Op Only- All Other Plans	$523	386%

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 $61.
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 Tehachapi Valley 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.