CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Adventist Health Howard Memorial

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $151
Cash Discount Price: $58
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Adventist Health Howard Memorial is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.28x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $58 (49%)

Insurance Median: $151 (128%)

Cash: $58 (49% of Medicare)

Ins. Median: $151 (128% 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%
Tricare	$71 - $403	60%
Aetna	$77 - $151	65%
Ah Employee Health Plan - All Plans	$78 - $117	66%
Cigna	$87 - $191	74%
UnitedHealthcare	$97	83%
Western Growers/Pinnacle - All Plans	$102 - $169	87%
Healthnet - All Plans	$104 - $184	88%
Brms - All Plans	$136 - $191	116%
Blue Cross Blue Shield	$147 - $185	125%
Blue Shield - All Other Plans	$154 - $163	131%
Blue Shield Epn	$154	131%
First Health Ppo - All Plans	$180	153%
Ghn Ppo - All Plans	$180	153%
Blue Shield Mcare	$403	343%
Medicare (plans)	$407	346%

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 $58.
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 Howard Memorial 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.