CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $467
Cash Discount Price: $769
vs. Medicare Baseline: 3.97x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at HCA Healthone Presbyterian St Luke's is $467. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $769. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 3.97x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$769

Average discount available for prompt cash payment at this facility.

Insurance Median

$467

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: $769 (654%)

Insurance Median: $467 (397%)

Cash: $769 (654% of Medicare)

Ins. Median: $467 (397% 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 397% of the Medicare baseline (a markup of 297%). 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
Vail Health	$103 - $233	88%
Kaiser	$136 - $398	116%
United	$140 - $688	119%
Cigna	$197 - $979	168%
Aetna	$204 - $808	174%
Bright Health	$204 - $459	174%
Emerging Therapy Solutions	$326 - $979	277%
Kaiser National Transplant	$326 - $734	277%
Colorado Program For Children With Special Needs	$346 - $780	294%
Western Plains Community Health	$441 - $994	375%
Multiplan	$475 - $1,377	404%
Northcare	$475 - $1,071	404%
Physician Health Partners	$475 - $1,071	404%
Blue Cross Blue Shield	$502 - $1,132	427%
Pinnacol Workers Comp	$509 - $1,147	433%
Medical Development International	$543 - $1,224	462%
Triwest Health Alliance	$543 - $1,224	462%
Prime Health	$611 - $1,377	520%

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 $769.
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 HCA Healthone Presbyterian St Luke's 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.