New patient office visit (30-44 min)
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $248
- Cash Discount Price: $488
- vs. Medicare Baseline: 2.11x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 211% of the Medicare baseline (a markup of 111%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Allied Physicians | $46 | 39% |
| Applecare Medical Group | $46 | 39% |
| Heritage Provider Network | $46 - $77 | 39% |
| Non Contracted Medi-Cal | $46 | 39% |
| Talbert Medical Group | $46 - $84 | 39% |
| Msi/Medical Services For Indigents | $52 | 44% |
| Ahmc Reciprocity Agreement | $57 - $164 | 48% |
| Altamed Health Network | $57 | 48% |
| Beverly Hospital | $57 | 48% |
| Brand New Day | $57 - $327 | 48% |
| Health Net | $57 | 48% |
| Healthcare Partners | $57 | 48% |
| Healthy Way La | $57 | 48% |
| Blue Cross Blue Shield | $59 - $104 | 50% |
| Caloptima | $64 - $82 | 54% |
| Monarch Health Plan | $64 - $545 | 54% |
| Aids Health Foundation | $66 | 56% |
| Avanti | $66 | 56% |
| Emanate Health | $66 | 56% |
| Health Net Inc | $66 - $419 | 56% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $66 | 56% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $66 | 56% |
| Hollywood Presbyterian Medpoint Mcal | $66 | 56% |
| Medi-Cal | $66 | 56% |
| Genesis Healthcare Ipa Ancillary | $72 | 61% |
| Monarch Healthcare Medical Group | $74 | 63% |
| Prospect Medical Group | $76 | 65% |
| Netcare Life And Health Insurance | $80 - $136 | 68% |
| Prospect Health Plan | $80 | 68% |
| Kaiser Foundation Hospitals | $82 | 70% |
| Medical Safety Net Program | $82 | 70% |
| Angels Baseball Workers Comp | $88 | 75% |
| Memorial Healthcare Ipa | $92 - $164 | 78% |
| Interplan | $93 - $382 | 79% |
| Advance Clinical Research Institute | $95 - $164 | 81% |
| First Health | $101 - $463 | 86% |
| Orange County Preferred Provider Organization | $101 - $409 | 86% |
| Athens Administrators | $104 | 88% |
| Capp Care | $104 - $409 | 88% |
| Cigna | $104 - $278 | 88% |
| Corvel | $104 - $409 | 88% |
| Marriot Intl | $104 | 88% |
| Non Contracted Workers Comp | $104 | 88% |
| Medical Acquisition Company | $127 - $218 | 108% |
| Affiliated Doctors Of Orange County | $143 - $245 | 122% |
| Medicare (plans) | $159 - $272 | 135% |
| UnitedHealthcare | $159 - $272 | 135% |
| Aetna | $165 - $283 | 140% |
| Davita Heatlhcare Partners Plan Inc | $172 - $294 | 146% |
| Healthcare Partners Commercial | $172 - $294 | 146% |
| Huntington Memorial Hospital | $172 - $294 | 146% |
| Scan Health Plan | $207 - $354 | 176% |
| Affiliated Health Fund | $223 - $382 | 190% |
| Allnet Preferred Provider | $223 - $382 | 190% |
| Care First | $223 - $382 | 190% |
| Private Healthcare Systems | $223 - $382 | 190% |
| Choicecare | $238 - $409 | 202% |
| Multiplan Inc | $238 - $409 | 202% |
| Blue Shield Of California | $248 - $431 | 211% |
| National Provider Network | $254 - $436 | 216% |
| Three Rivers Providers Network | $254 - $436 | 216% |
| Health Payors Organization | $286 - $490 | 243% |
| Non Contracted Commercial | $318 - $545 | 270% |
| Tricare | $318 - $545 | 270% |