CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: USA Health Children's & Women's Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $118
Cash Discount Price: $171
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at USA Health Children's & Women's Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.00x the Medicare baseline. Located in 1700 Center Street, Mobile, AL.

Cash / Self-Pay

$171

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)

Cash / Self-Pay: $171 (145%)

Insurance Median: $118 (100%)

Cash: $171 (145% of Medicare)

Ins. Median: $118 (100% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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
Magnolia Health	$68	58%
Truecare	$68	58%
UnitedHealthcare	$68 - $118	58%
Molina Chip	$75	64%
Cigna	$81 - $111	69%
Central Healthcare Services	$86 - $175	73%
Viva Health	$86 - $118	73%
Aetna	$94 - $118	80%
Humana	$111 - $118	94%
Multiplan	$111 - $120	94%
Blue Cross Blue Shield	$115	98%
Devoted Health	$118 - $120	100%
Wellcare	$118	100%
Molina Marketplace	$129	110%
Ambetter / Centene	$141	120%
Novanet	$154	131%
Mississippi Physicians Care Network (Mpcn)	$159	135%

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 $171.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm USA Health Children's & Women's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
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.