CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: HCA Healthone Mountain Ridge

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $389
Cash Discount Price: $692
vs. Medicare Baseline: 3.31x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at HCA Healthone Mountain Ridge is $389. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $692. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 3.31x the Medicare baseline. Located in 9191 Grant St, Thornton, CO.

Cash / Self-Pay

$692

Average discount available for prompt cash payment at this facility.

Insurance Median

$389

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: $692 (589%)

Insurance Median: $389 (331%)

Cash: $692 (589% of Medicare)

Ins. Median: $389 (331% 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 331% of the Medicare baseline (a markup of 231%). 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	$86 - $124	73%
Kaiser	$107 - $290	91%
United	$118 - $367	100%
Aetna	$170 - $431	145%
Bright Health	$170 - $245	145%
Colorado Program For Children With Special Needs	$193 - $277	164%
Life Source Services	$350	298%
Cigna	$364 - $522	310%
Western Plains Community Health	$369 - $530	314%
Multiplan	$398 - $734	339%
Northcare	$398 - $571	339%
Physician Health Partners	$398 - $571	339%
Blue Cross Blue Shield	$420 - $604	357%
Pinnacol Workers Comp	$426 - $612	362%
Medical Development International	$455 - $653	387%
Triwest Health Alliance	$455 - $653	387%
Prime Health	$511 - $734	435%

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 $692.
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 Mountain Ridge 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.