CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: City of Hope National Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $193
  • Cash Discount Price: $258
  • vs. Medicare Baseline: 1.64x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at City of Hope National Medical Center is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $258. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.64x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.
Cash / Self-Pay
$258

Average discount available for prompt cash payment at this facility.

Insurance Median
$193

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: $258 (219%)
Insurance Median: $193 (164%)
Cash: $258 (219% of Medicare)
Ins. Median: $193 (164% 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
Health Net $50 - $302 43%
Heritage Provider Network $62 - $180 53%
Cal Optima $84 - $100 71%
Inland Empire $98 - $206 83%
Blue Shield Covca $119 101%
Facey $120 102%
Blue Cross Blue Shield $129 - $180 110%
UnitedHealthcare $144 - $278 122%
Prime Healthcare Keenan $147 - $247 125%
Blue Shield $152 - $231 129%
Cigna $169 144%
Blue Shield Promise $180 153%
Cencal $206 175%
La Care Health $206 175%
Kaiser $232 197%
Aetna $258 219%
Gold Coast $258 219%
Molina $258 - $335 219%
Healthcare Partners $299 254%
St. Joseph Heritage $309 263%
Primecare Medical Network $335 285%
First Health $397 338%
Phcs Multiplan $464 395%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 Duarte Rd, Duarte, CA 91010
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL