CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: UCSF Health St. Mary's Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $136
  • Cash Discount Price: $184
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at UCSF Health St. Mary's Hospital is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $184. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.16x the Medicare baseline. Located in 450 Stanyan St, San Francisco, CA.
Cash / Self-Pay
$184

Average discount available for prompt cash payment at this facility.

Insurance Median
$136

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: $184 (157%)
Insurance Median: $136 (116%)
Cash: $184 (157% of Medicare)
Ins. Median: $136 (116% 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
Sfhp $80 68%
Blue Cross Blue Shield $102 - $184 87%
California Health & Wellness $102 87%
Health Plan San Mateo $102 87%
Kaiser $102 - $140 87%
Partnership Health Plan $102 87%
Magellan $110 94%
Healthsmart $129 110%
Brown Toland $133 113%
Blue Shield Ca $139 - $184 118%
Health Net $149 127%
Multiplan $153 130%
Chinese Community $167 142%
United $184 157%
Us Behavioral Health $184 157%
Cigna $206 - $219 175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 450 Stanyan St, San Francisco, CA 94117
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals