CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Riverside Community Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $148
  • Cash Discount Price: $494
  • vs. Medicare Baseline: 1.26x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Riverside Community Hospital is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $494. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.26x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.
Cash / Self-Pay
$494

Average discount available for prompt cash payment at this facility.

Insurance Median
$148

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: $494 (420%)
Insurance Median: $148 (126%)
Cash: $494 (420% of Medicare)
Ins. Median: $148 (126% 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
Aetna $49 - $89 42%
Medcare Partners $74 63%
La Care Health $82 70%
Molina $82 70%
Brand New Day $90 77%
Health Net $110 94%
Inland Empire Health Plan $119 101%
United $130 111%
Redlands Community $148 126%
Blue Shield $159 - $256 135%
First Health $217 - $445 185%
American Health System $222 189%
Riverside Medical Clinic $321 273%
Riverside Physician $321 273%
Healthsmart $395 336%
Multiplan $395 - $420 336%
Next $395 336%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4445 Magnolia Avenue, Riverside, CA 92501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals