CMS Price Transparency Data
New patient office visit (30-44 min)
Facility: San Antonio Regional Hospital
Billing Code: 99203 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99203
- Insurance Median: $123
- Cash Discount Price: $152
- vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at San Antonio Regional Hospital is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.05x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$152
Average discount available for prompt cash payment at this facility.
Insurance Median
$123
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: $152 (129%)
Insurance Median: $123 (105%)
Cash: $152 (129% of Medicare)
Ins. Median: $123 (105% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ambetter / Centene | $55 | 47% |
| Tricare | $71 | 60% |
| Blue Shield Mcr Adv | $73 | 62% |
| Caremore Mcr Adv - All Plans | $73 | 62% |
| Choice Phycn Ntwrk Mcr Adv-All Other Plans | $73 | 62% |
| Healthnet Mcr Adv | $73 | 62% |
| Humana | $73 | 62% |
| Iehp Mcr Adv | $73 | 62% |
| Inter Valley Hp Mcr Adv- All Plans | $73 | 62% |
| Kindred Mcr Adv-All Plans | $73 | 62% |
| Molina Mcr Adv | $73 | 62% |
| Scan Health Plan Mcr Adv-All Plans | $73 | 62% |
| Universal Care - All Plans | $73 | 62% |
| Blue Cross Blue Shield | $74 - $5,494 | 63% |
| Zelis Mcr Adv | $77 | 65% |
| Kasiser Mcr Adv | $78 | 66% |
| Imperial Health Mcr Adv-All Plans | $80 | 68% |
| Medi-Cal | $82 | 70% |
| Kaiser Medi-Cal | $86 | 73% |
| Healthnet Medi-Cal | $87 | 74% |
| Alpha Care Mg Mcal/Hlthy Kids | $90 | 77% |
| Heritage Prov Ntwrk/Regal Mcal | $90 | 77% |
| Choice Phycn Ntwrk Op Only | $91 | 77% |
| Epic Health Plan - All Other Plans | $91 | 77% |
| Molina Medi-Cal | $94 | 80% |
| Molina Exchange-All Other Plans | $95 | 81% |
| Aetna | $98 - $303 | 83% |
| Iehp Comm - All Other Plans | $106 | 90% |
| Iehp Mcal | $107 | 91% |
| Blue Shield Hmo Pos / Calpers Ppo | $109 | 93% |
| Redlands Employee | $109 | 93% |
| Redlands Hmo-All Other Plans | $114 | 97% |
| Blue Shield Epo Ppo - All Other Plans | $118 | 100% |
| Prime Health - All Plans | $128 | 109% |
| Pc Inland Valley Scan | $152 | 129% |
| Pc Inland Valley-All Other Plans | $152 | 129% |
| UnitedHealthcare | $152 - $2,060 | 129% |
| Coventry Ccn/First Hlth - All Plans | $167 | 142% |
| Healthnet - All Other Plans | $174 | 148% |
| Kaiser Comm - All Other Plans | $203 | 173% |
| Choicecare Ntwrk-All Plans | $218 | 185% |
| Multiplan/Phcs - All Plans | $218 | 185% |
| Networks By Design - All Plans | $227 | 193% |
| Zelis Comm-All Other Plans | $227 | 193% |
| Foundation Inland Epo-All Other Plans | $242 | 206% |
| Foundation Inland Ppo | $258 | 219% |
| Health Payors - All Plans | $273 | 232% |
| Interplan - All Plans | $273 | 232% |
| Wellcare/Easy Choice-All Plans | $297 | 253% |
| Alpha Care Mg Mcr Adv | $303 | 258% |
| Central Hlth Plan Mcr Adv-All Plans | $303 | 258% |
| Epic Health Plan Mcr Adv | $303 | 258% |
| Prospect Hp-All Plans | $303 | 258% |
| Providence Clevercare Mcr Adv | $303 | 258% |
| Heritage Prov Ntwrk/Regal Mcr Adv | $308 | 262% |
| Clever Care Mcr Adv - All Plans | $318 | 270% |
| La Salle Hp Mcr Adv-All Plans | $318 | 270% |
| Alpha Care Mg-All Other Plans | $379 | 322% |
| Providence Oscar-All Other Plans | $439 | 373% |
| Heritage Prov Ntwrk/Regal - All Other Plans | $557 | 474% |
| Cigna | $4,459 | 3793% |