CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: HCA Florida Orange Park Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $501
Cash Discount Price: $2,178
vs. Medicare Baseline: 4.26x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at HCA Florida Orange Park Hospital is $501. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,178. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 4.26x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.

Cash / Self-Pay

$2,178

Average discount available for prompt cash payment at this facility.

Insurance Median

$501

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: $2,178 (1853%)

Insurance Median: $501 (426%)

Cash: $2,178 (1853% of Medicare)

Ins. Median: $501 (426% 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 426% of the Medicare baseline (a markup of 326%). 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	$53 - $915	45%
Corvel Corporation	$82 - $253	70%
Prime Health	$83 - $258	71%
Optimum Healthcare	$84 - $276	71%
United	$119 - $1,708	101%
Simply Healthcare	$153 - $506	130%
Aetna	$171 - $1,139	145%
Positive Healthcare	$219 - $722	186%
Cigna	$238 - $929	202%
Sunshine State Health Plan	$254 - $968	216%
Molina Healthcare	$269 - $1,025	229%
Humana	$408 - $1,346	347%
Medicare (plans)	$448 - $1,478	381%
Plotkin Health	$497 - $1,898	423%
Oscar	$607	516%
Multiplan	$776 - $3,227	660%
Evernorth	$796 - $3,037	677%
Evolutions Healthcare	$796 - $3,227	677%
Ppo Next	$846 - $3,227	720%
Novanet	$895 - $3,417	761%
United Behavioral Health	$995 - $3,797	846%
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 $2,178.
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 Orange Park 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.