CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Adventist Health Mendocino Coast

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $168
Cash Discount Price: $148
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Adventist Health Mendocino Coast is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $148. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.24x the Medicare baseline. Located in 700 River Drive, Fort Bragg, CA.

Cash / Self-Pay

$148

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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: $148 (109%)

Insurance Median: $168 (124%)

Cash: $148 (109% of Medicare)

Ins. Median: $168 (124% 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%
Partnership Hp Mcal-All Plans	$54 - $161	40%
Cigna	$85 - $202	63%
Tricare	$85 - $279	63%
Ah Employee Health Plan - All Plans	$93 - $135	69%
Blue Shield Epn	$98 - $148	72%
UnitedHealthcare	$102	75%
Blue Cross Blue Shield	$105 - $220	77%
Healthnet - All Plans	$124 - $169	91%
Blue Shield - All Other Plans	$157 - $199	116%
Great West Hmo/Pos/Epo/Oa	$168 - $190	124%
Great West Ppo - All Other Plans	$181 - $190	133%
Multiplan - All Plans	$181 - $190	133%
Ahcc - All Plans	$190 - $233	140%
Beech Street - All Plans	$190 - $233	140%

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 $148.
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 Mendocino Coast 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.