CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: West Valley Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $255
  • Cash Discount Price: $494
  • vs. Medicare Baseline: 1.88x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at West Valley Medical Center is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $494. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.88x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.
Cash / Self-Pay
$494

Average discount available for prompt cash payment at this facility.

Insurance Median
$255

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: $494 (364%)
Insurance Median: $255 (188%)
Cash: $494 (364% of Medicare)
Ins. Median: $255 (188% 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
Regence Blue Shield $50 37%
Blue Cross Blue Shield $79 - $677 58%
Molina $79 58%
Select Health Idaho (Eirmc Only) $88 - $227 65%
Corizon Health $102 - $264 75%
True Blue $109 - $282 80%
Pacificsource Health $165 - $425 122%
United $165 - $425 122%
Moda $172 - $444 127%
St Luke'S Health Partners $179 - $463 132%
Aetna $218 - $564 161%
Four Rivers Hospice $220 - $570 162%
Multiplan $220 - $570 162%
Humana $232 - $599 171%
Geha Ppo Usa $234 - $606 173%
Coventry First Health $248 - $641 183%
St Alphonsus Health $248 - $641 183%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1717 Arlington Street, Caldwell, ID 83605
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals