CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Valley Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $102
  • Cash Discount Price: $354
  • vs. Medicare Baseline: 0.75x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Valley Medical Center is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $354. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.75x the Medicare baseline. Located in 400 S 43Rd St, Renton, WA.
Cash / Self-Pay
$354

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $354 (261%)
Insurance Median: $102 (75%)
Cash: $354 (261% of Medicare)
Ins. Median: $102 (75% 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
Bh Managed Health Network [130106] $36 27%
Bh Mnh [130108] $36 27%
Aetna $67 - $242 49%
Allied Benefit Systems Llc [110104] $67 - $106 49%
Humana $74 - $250 55%
Multiplan Phcs [130109] $74 - $136 55%
Kaiser Washington Contracted [130118] $76 - $117 56%
First Choice Health Administrators [150110] $83 61%
Chpw Med Advantage [210102] $102 75%
Medicare (plans) $102 - $107 75%
Premera Medadvantage [210114] $102 75%
Regence Medadvantage [210111] $102 75%
UnitedHealthcare $102 75%
Wellpoint Medadvantage [210115] $102 75%
Chpw [130116] $124 - $246 91%
Molina [130117] $131 - $262 97%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 S 43Rd St, Renton, WA 98055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals