CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Phoenix Children's Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $110
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Phoenix Children's Hospital is $110. 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 $117.57, this hospital’s rate is 0.94x the Medicare baseline. Located in 1919 East Thomas Road, Phoenix, AZ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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%)
Insurance Median: $110 (94%)
Ins. Median: $110 (94% 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.

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
Ahccs $22 - $99 19%
Ahc Apipa $39 33%
Ahc Cmdp $39 33%
Ahc Crs $39 - $99 33%
Ahc Ihs $39 33%
Ahc Mercy Care $39 33%
Ahc University $43 37%
Ahc Healthchoice $52 44%
Ahc Lcd $55 47%
Ahc Care First $99 84%
Healthcomp $104 - $107 88%
Intel $104 - $107 88%
UnitedHealthcare $113 - $126 96%
Aetna $119 - $196 101%
Antidote $169 - $174 144%
Cigna $181 - $214 154%
Multiplan $208 - $214 177%
Selfpay $220 187%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1919 East Thomas Road, Phoenix, AZ 85016
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens