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Office visit, new patient, 60-74 min

CPT 99205 · negotiated-rate distribution across hospitals in CA

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Hospitals
33
Min
$118.62
Median
$372.58
Max
$3,715.35
Range multiplier
31.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare25129$116.70$486.00$5,318.0045.6×
Medicaid2176$117.44$193.35$505.004.3×
Multiplan2354$140.80$449.22$5,211.6437.0×
Kaiser Permanente1948$70.15$391.53$5,318.0075.8×
Blue Cross Blue Shield1239$1.00$386.00$3,993.823993.8×
Health Net1237$1.00$486.25$5,115.925115.9×
First Health1637$197.40$378.75$5,211.6426.4×
Cigna1334$152.00$285.38$4,211.8627.7×
Anthem BCBS2133$70.15$160.49$3,035.0043.3×
Aetna1032$70.15$423.87$3,860.8755.0×
commercial | healthsmart | all plans1231$117.80$435.80$3,496.8029.7×
commercial | sutter health | all plans515$366.40$388.80$404.001.1×
Humana812$70.15$229.88$669.949.6×
Molina812$118.62$496.50$763.006.4×
Medicare89$70.15$169.00$571.908.2×
commercial | wcmg | all plans39$77.86$82.62$85.851.1×
commercial | connected care intel | all plans38$203.00$278.69$1,946.559.6×
commercial | magellan | all plans26$101.40$314.40$922.209.1×
commercial | us behavioral health| all plans15$344.00$675.00$1,537.004.5×
health plan of san mateo [31200]15$231.56$289.45$289.451.3×
claritev [13400]15$448.55$575.73$575.731.3×
private healthcare systems (phcs) [14200]15$448.55$575.73$575.731.3×
beech st [10600]15$448.55$575.73$575.731.3×
indian health council34$326.80$516.59$622.401.9×
traditional medi-cal44$118.62$118.62$118.621.0×
commercial | us behavior health | all plans14$562.00$707.00$1,265.002.3×
county medical services23$1.15$392.16$392.16341.0×
shca comm intel [20300000]13$612.31$612.31$612.311.0×
umr [17000]13$769.75$769.75$769.751.0×
blue card (out of state) [40000]13$612.31$612.31$612.311.0×
commercial | usbehavior health | all plans13$458.00$486.00$505.001.1×
american specialty health plan alt payer [971000000]13$823.49$823.49$823.491.0×
aids healthcare foundation22$118.62$118.62$118.621.0×
commercial | sea view | all plans22$226.22$226.22$226.221.0×
community health group22$544.60$578.68$612.751.1×
epic americas22$231.07$421.91$612.752.7×
caloptima22$118.62$118.62$118.621.0×
california health and wellness22$343.14$404.97$466.801.4×
heritage provider network12$575.00$669.00$763.001.3×
brand new day22$841.19$893.92$946.651.1×
interplan22$490.14$522.85$555.561.1×
l.a care health plan22$118.62$118.62$118.621.0×
altamed12$575.00$669.00$763.001.3×
optum health12$521.26$521.26$521.261.0×
san diego pace12$10.20$311.48$612.7560.1×
the health plan12$136.91$136.91$136.911.0×
umr11$184.86$184.86$184.861.0×
optum health plan of california11$118.62$118.62$118.621.0×
kindred hospital la11$118.62$118.62$118.621.0×
commercial | healthcare partners | all plans11$44.30$44.30$44.301.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
St. Bernardine Medical CenterSan BernardinoCA13$1,385.00$969.50$118.62$914.10$3,035.00
St. Johns Pleasant Valley HospitalCamarilloCA8$1,981.00$1,386.70$118.62$881.55$1,981.00
Sequoia HospitalRedwood CityCA8$4,548.00$3,183.60$118.62$853.89$4,548.00
St Elizabeth Community HosptialRed BluffCA10$5,318.00$3,722.60$164.88$605.00$5,318.00
Stanford Health CareStanfordCA14$1,107.00$553.50$231.56$575.73$823.49
Pacifica Hospital Of The ValleySun ValleyCA5$763.00$763.00$288.00$575.00$763.00
Marian Medical CenterSanta MariaCA6$750.00$525.00$118.62$550.21$750.00
Grossmont HospitalLa MesaCA6$817.00$612.75$264.52$523.73$622.40
Sharp Memorial HospitalSan DiegoCA15$817.00$612.75$122.55$521.26$800.66
Sierra Nevada Memorial HospitalGrass ValleyCA7$564.00$394.80$118.62$476.90$555.54
Sharp Chula Vista Medical CenterChula VistaCA17$817.00$612.75$1.00$431.79$1,498.14
Woodland HealthcareWoodlandCA12$505.00$353.50$77.86$411.77$505.00
Saint Francis Memorial HospitalSan FranciscoCA8$1,537.00$1,075.90$118.62$405.00$1,537.00
Methodist Hospital Of SacramentoSacramentoCA10$505.00$353.50$118.62$374.87$505.00
Mercy San Juan Medical CenterCarmichaelCA9$505.00$353.50$77.86$372.58$505.00
Dominican HospitalSanta CruzCA6$4,371.00$3,059.70$118.62$3,715.35$4,371.00
Mercy Hospital Of FolsomFolsomCA10$505.00$353.50$77.86$370.07$505.00
Mercy General HospitalSacramentoCA9$505.00$353.50$118.62$367.11$505.00
Mercy Medical Center Mt. ShastaMt. ShastaCA12$386.00$270.20$143.53$338.91$386.00
Northridge Medical Center - RoscoeNorthridgeCA7$1,265.00$885.50$44.30$328.90$1,265.00
Bakersfield Memorial HospitalBakersfieldCA7$706.00$494.20$118.62$282.00$706.00
Mark Twain Medical CenterSan AndreasCA12$458.00$320.60$70.15$246.14$448.84
Mercy Medical Center MercedMercedCA7$434.00$303.80$118.62$244.01$405.79
St. Johns Regional Medical CenterOxnardCA7$402.00$281.40$108.54$237.73$402.00
St. Mary Medical CenterApple ValleyCA6$570.00$399.00$118.62$181.49$509.07
San Antonio Regional HospitalUplandCA5$421.00$252.60$136.91$170.73$205.92
St. Marys Medical CenterSan FranciscoCA9$169.00$118.30$101.40$144.12$169.00
Glendale Memorial Hospital & Hlth CtGlendaleCA2$810.00$567.00$103.00$144.00$648.00
Sherman Oaks Hospital-HlthSherman OaksCA7$1,297.00$118.62$118.62$126.92
Centinela Hospital Medical CenterInglewoodCA10$1,731.05$118.62$118.62$130.48
Huntington Beach HospitalHuntington BeachCA6$841.19$118.62$118.62$841.19
Garden Grove Hospital Medical CenterGarden GroveCA5$946.65$118.62$118.62$946.65
Tri-City Medical CenterOceansideCA0$419.00$251.40

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.