CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Martin Luther King, Jr. Community Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $146
Cash Discount Price: $129
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Martin Luther King, Jr. Community Hospital is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.24x the Medicare baseline. Located in 1680 East 120Th Street, Los Angeles, CA.

Cash / Self-Pay

$129

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $129 (110%)

Insurance Median: $146 (124%)

Cash: $129 (110% of Medicare)

Ins. Median: $146 (124% 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.

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
Preferred Professional Medical Corporation (Ipa) Of California	$59 - $77	50%
Alta	$101 - $129	86%
Brand New Day	$101 - $407	86%
Care1St Health	$101 - $129	86%
Molina Healthcare	$106 - $161	90%
Heritage Provider Network (Hpn)	$122	104%
Health Net	$146 - $263	124%
La Care Health Pasc-Seui	$151	128%
La Care Health Plan	$151	128%
La Care Health	$182	155%
Blue Shield Of California	$278 - $308	236%
UnitedHealthcare	$291	248%
Santa Monica Unite Here	$405	344%
Multiplan	$542	461%

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 $129.
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 Martin Luther King, Jr. Community Hospital 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.