CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mayers Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $351
  • Cash Discount Price: $441
  • vs. Medicare Baseline: 2.99x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mayers Memorial Hospital is $351. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.99x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.
Cash / Self-Pay
$441

Average discount available for prompt cash payment at this facility.

Insurance Median
$351

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: $441 (375%)
Insurance Median: $351 (299%)
Cash: $441 (375% of Medicare)
Ins. Median: $351 (299% 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 299% of the Medicare baseline (a markup of 199%). 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.

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
Medi-Cal $57 - $82 48%
Blue Cross Blue Shield $219 - $469 186%
Blue Shield Ca Exchange $244 - $469 208%
Blue Shield-All Other Plans $271 - $521 231%
Cigna $271 - $521 231%
Corvel Ppo-All Plans $271 - $521 231%
Coventry/First Health-All Plans $271 - $521 231%
Hmn-All Plans $271 - $521 231%
Integrated Hp-All Plans $271 - $521 231%
Interplan-All Plans $271 - $521 231%
Multiplan Phcs-All Plans $271 - $521 231%
Pfmc-All Plans $271 - $521 231%
Superior Ca-All Plans $271 - $521 231%
Health Net-All Other Plans $284 - $545 242%
Pacificare-All Plans $285 - $548 242%
Partnership Hp-All Plans $285 - $328 242%
Arcadian Health Services-All Plans $309 - $362 263%
Blue Shield Ca Va $313 - $344 266%
Blue Shield Mcr Adv $313 - $344 266%
Health Net Mcr Adv $329 - $362 280%
Tricare $329 - $362 280%
Health Net Prison $359 - $394 305%
Imperial Health Plan-All Plans $372 - $409 316%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43563 Hwy 299 East, Fall River Mills, CA 96028
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals