CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Sharp Coronado Hospital and Hlthcr Ctr

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $280
Cash Discount Price: $345
vs. Medicare Baseline: 2.38x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Sharp Coronado Hospital and Hlthcr Ctr is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.38x the Medicare baseline. Located in 250 Prospect Place, Coronado, CA.

Cash / Self-Pay

$345

Average discount available for prompt cash payment at this facility.

Insurance Median

$280

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: $345 (293%)

Insurance Median: $280 (238%)

Cash: $345 (293% of Medicare)

Ins. Median: $280 (238% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 238% of the Medicare baseline (a markup of 138%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicare (plans)	$28 - $346	24%
Health Net	$30 - $359	26%
Blue Cross Blue Shield	$71 - $440	60%
Blue Shield	$71 - $359	60%
Allianz Global Assistance	$133 - $337	113%
California Health And Wellness	$133 - $226	113%
Cigna	$133 - $314	113%
San Diego Pace	$133 - $424	113%
Aetna	$140 - $377	119%
Indian Health Council	$153 - $330	130%
Kaiser	$153 - $300	130%
Molina	$153 - $353	130%
Epic Americas	$160	136%
Multiplan	$189 - $462	161%
Managed Health Network	$226 - $353	192%
Medi-Cal	$226 - $286	192%
UnitedHealthcare	$254 - $353	216%
Humana	$262	223%
Community Health Group	$278 - $359	236%
Interplan	$283	241%
County Medical Services	$314	267%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $345.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sharp Coronado Hospital and Hlthcr Ctr is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.