CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Clovis Community Medical Center
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $141
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Clovis Community Medical Center is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.04x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$141
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%)
Insurance Median: $141 (104%)
Ins. Median: $141 (104% 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 |
|---|---|---|
| Fresno County Funded Specialty Care | $116 | 86% |
| Chdp | $116 | 86% |
| San Francisco Health Plan Medi-Cal | $116 | 86% |
| Medi-Cal Health Plan of San Mateo | $116 | 86% |
| Cal Caloptima | $116 | 86% |
| Medi-Cal Contra Costa Health Plan | $116 | 86% |
| Medi-Cal California Health & Wellness Plan | $116 | 86% |
| Ccs Kings | $116 | 86% |
| Gold Coast Medi-Cal | $116 | 86% |
| Ccs Merced | $116 | 86% |
| Medi-Cal Partnership Health Plan of Ca | $116 | 86% |
| Santa Clara Family Health Plan - Premier Health | $116 | 86% |
| Blue Cross Blue Shield | $116 - $141 | 86% |
| Ccs Kern | $116 | 86% |
| Medi-Cal Molina | $116 | 86% |
| Medi-Cal La Care Health | $116 | 86% |
| Medi-Cal Kern Family Health | $116 | 86% |
| Medi-Cal Community Health Group | $116 | 86% |
| Ccs Mariposa | $116 | 86% |
| Ccs Fresno | $116 | 86% |
| Ccs Madera/Sacramento | $116 | 86% |
| Medi-Cal Blue Shield Promise Health | $116 | 86% |
| Ccs Stanislaus | $116 | 86% |
| Generic Care Out of County | $116 | 86% |
| Blue Shield | $116 - $141 | 86% |
| Medi-Cal Alameda Alliance for Health | $116 | 86% |
| Ccs Tulare | $116 | 86% |
| Genetically Handicapped Person | $116 | 86% |
| Medi-Cal Cencal Health | $116 | 86% |
| Generic Ccs Other Counties | $116 | 86% |
| Medi-Cal Inland Empire Health | $116 | 86% |
| Santa Clara Family Health Plan - Valley Health | $116 | 86% |
| Blue Shield Promise - Imperial | $141 | 104% |
| Bscphp - Dhmso | $141 | 104% |
| Scan Health Plan | $141 | 104% |
| Healthnet Sante - Sub Cap Dual Risk | $141 | 104% |
| Healthnet Sante | $141 | 104% |
| Sante Sub Cap Healthnet Seniority | $141 | 104% |
| Healthnet Sante Dual Risk | $141 | 104% |
| Blue Shield Saint Agnes | $141 | 104% |
| Blue Shield Sante | $141 | 104% |
| Generic Bscphp | $141 | 104% |
| Wellcare | $141 | 104% |
| Aetna | $141 - $320 | 104% |
| Sante Sub Cap-Blue Shield/Sante | $141 | 104% |
| Healthnet HMO - Sante | $141 | 104% |
| Well Path (Cfmg) | $141 | 104% |
| Blue Shield 65 Plus HMO Ehs | $141 | 104% |
| Bscphp - First Choice | $141 | 104% |
| Healthnet HMO - Cvmp/Medpro | $141 | 104% |
| Advantek Table Mountain Rancheria Tribal Member | $141 | 104% |
| Medicare (plans) | $141 | 104% |
| Railroad Part B | $141 | 104% |
| Meritage Blue Shield 65 Plus | $141 | 104% |
| Hartford Life Supplement | $141 | 104% |
| Kaiser | $141 | 104% |
| Healthnet HMO - La Salle | $141 | 104% |
| Sante-Blue Shield/Sante | $141 | 104% |
| Blue Shield Hmo-Cvmp/Medpro | $141 | 104% |
| Generic Victims of Crime | $141 | 104% |
| Bscphp HMO - First Choice | $141 | 104% |
| Gemcare HMO | $141 | 104% |
| Sequoia Pace - Peak Tpa | $141 | 104% |
| Generic | $141 | 104% |
| Blue Shield 65 Plus HMO First Choice | $141 | 104% |
| Todays Pyramid | $141 | 104% |
| Cares Act Provider Relief Fund | $141 | 104% |
| Sante-Sub Cap Ma Brand New Day | $141 | 104% |
| Brand New Day | $141 | 104% |
| Victims of Crime | $141 | 104% |
| UnitedHealthcare | $141 - $143 | 104% |
| Us Marshal | $141 | 104% |
| Medi-Cal Innovative Integrated Health | $141 | 104% |
| Sante-Healthnet Seniority | $141 | 104% |
| Cigna | $141 | 104% |
| Sante | $141 - $180 | 104% |
| Meritage Brand New Day | $141 | 104% |
| Healthnet HMO - Dhmso | $141 | 104% |
| Meritage Healthnet HMO | $141 | 104% |
| Humana | $141 | 104% |
| Railroad Part A | $141 | 104% |
| Care1St HMO - Ehs | $141 | 104% |
| Railroad Part A & B | $141 | 104% |
| Alignment Health Plan | $155 | 114% |
| Champion Health Plan of California Ma | $155 | 114% |
| Innovative Integrated Health Community Plans HMO | $155 | 114% |
| Imperial Health Plan HMO | $162 | 119% |
| Sequoia Pace | $174 | 128% |
| Health Plan of San Joaquin | $174 | 128% |
| Correctcare Integrated Health | $183 | 135% |
| Adventist -McL Calviva Sub Cap | $191 | 141% |
| Healthnet | $223 | 164% |
| Coalinga State Hospital | $282 | 208% |
| Naphcare Inc-Mendota | $303 | 223% |