CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Banner Boswell Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $185
Cash Discount Price: $90
vs. Medicare Baseline: 1.57x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Banner Boswell Medical Center is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.57x the Medicare baseline. Located in 13632 N 99Th Ave, Sun City, AZ.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$185

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: $90 (77%)

Insurance Median: $185 (157%)

Cash: $90 (77% of Medicare)

Ins. Median: $185 (157% 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
Arizona Physicians Ipa	$55	47%
Banner University Health Plan	$55	47%
Health Choice Arizona, Inc.	$55 - $188	47%
Mercy Care	$55	47%
Aetna	$75 - $198	64%
Hospice Of The Valley	$131	111%
Arizona Priority Care	$150	128%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$169	144%
Plotkin Health	$169	144%
UnitedHealthcare	$182 - $200	155%
Oscar Health Plan	$188	160%
Quiktrip Corporation	$202	172%
Cigna	$246 - $258	209%
Provider Network Of America	$281	239%
Arizona Medical Network	$300	255%

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 $90.
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 Banner Boswell Medical Center 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.