CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: HCA Florida North Florida Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $265
Cash Discount Price: $1,071
vs. Medicare Baseline: 2.25x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at HCA Florida North Florida Hospital is $265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,071. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.25x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

$1,071

Average discount available for prompt cash payment at this facility.

Insurance Median

$265

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: $1,071 (911%)

Insurance Median: $265 (225%)

Cash: $1,071 (911% of Medicare)

Ins. Median: $265 (225% 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 225% of the Medicare baseline (a markup of 125%). 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
Blue Cross Blue Shield	$26 - $466	22%
Aetna	$27 - $555	23%
United	$59 - $832	50%
Simply	$60 - $285	51%
Cigna	$68 - $769	58%
Molina Healthcare	$75 - $592	64%
Humana	$79 - $370	67%
Corvel Corporation	$82 - $267	70%
Prime Health	$83 - $272	71%
Careworks (Rockport Community)	$86 - $281	73%
Sunshine State Health Plan	$100 - $472	85%
Avmed	$196 - $925	167%
Plotkin Health	$196 - $925	167%
Prime Health Sheriff	$196 - $925	167%
Corizon Phs	$236 - $1,110	201%
Multiplan	$306 - $1,572	260%
Evernorth	$314 - $1,480	267%
Evolutions Healthcare	$334 - $1,572	284%
Ppo Next	$334 - $1,572	284%
Novanet	$353 - $1,664	300%
Beacon Health Options	$393 - $1,849	334%
American Health Plan	$15,000	12758%

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 $1,071.
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 Florida North Florida 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.