CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Boulder Community Health

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $139
  • Cash Discount Price: $109
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Boulder Community Health is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.18x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$109

Average discount available for prompt cash payment at this facility.

Insurance Median
$139

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: $109 (93%)
Insurance Median: $139 (118%)
Cash: $109 (93% of Medicare)
Ins. Median: $139 (118% 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
Cigna $41 - $218 35%
Aetna $62 - $238 53%
Medicare (plans) $62 - $135 53%
Select Health Colorado Public Option $62 - $245 53%
Select Health Value Network $62 - $259 53%
Devoted Health $65 - $111 55%
UnitedHealthcare $80 - $153 68%
Humana $81 - $111 69%
Blue Cross Blue Shield $93 - $320 79%
Rocky Mountain Health Maintenance Organization $103 - $139 88%
Colorado Community Health Alliance (Ccha) $104 88%
Medicaid / KanCare $105 - $139 89%
Health Spring $111 94%
Multiplan $112 - $191 95%
Phcs $112 - $191 95%
Rocky Mountain Health Maintenance Organization Private Plan $113 - $191 96%
Clear Spring $115 98%
Colorado Access $115 - $181 98%
Integrated Health Plans Bch $122 - $205 104%
Beech Street Community Medical Associates $125 106%
Casualty Management Network, Prime Health Services Behavioral Health $138 - $232 117%
Mines And Associates $138 - $232 117%
Three Rivers Provider Network $138 - $232 117%
Zelis (Profee) $138 - $232 117%
Casualty Management Network, Prime Health Services Community Medical Associates $146 - $246 124%
National Preferred Provider Network $146 - $246 124%
Rockport Healthcare Group Community Medical Associates $146 - $246 124%
Usa $146 - $246 124%
Rockport Healthcare Group Bch $151 - $254 128%
Health Payors Organization $154 - $259 131%
Health Management Network Bch Community Medical Associates $156 - $262 133%
Health Management Network Community Medical Associates $156 - $262 133%
National Provider Network $157 - $265 134%
Kaiser Ppo $171 - $5,858 145%
Kaiser Public Option $171 - $4,905 145%
Kaiser $261 - $5,830 222%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals