CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: HCA Florida Northside Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $72
Cash Discount Price: $388
vs. Medicare Baseline: 0.61x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at HCA Florida Northside Hospital is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $388. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.61x the Medicare baseline. Located in 6000 49Th St N, Saint Petersburg, FL.

Cash / Self-Pay

$388

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $388 (330%)

Insurance Median: $72 (61%)

Cash: $388 (330% of Medicare)

Ins. Median: $72 (61% 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.

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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$18 - $21	15%
Blue Cross Blue Shield	$18 - $92	15%
Aetna	$23 - $132	20%
Suncoast Neighborly Care	$27	23%
Access 2 Healthcare Physicians Freedom Health	$28 - $32	24%
Access 2 Healthcare Physicians Optimum	$28 - $32	24%
Truli	$29 - $54	25%
Freedom Health Care	$30 - $34	26%
Optimum Healthcare	$30 - $34	26%
Simply Healthcare	$43 - $68	37%
Oscar	$50	43%
United	$55 - $198	47%
Cigna	$70 - $79	60%
Molina	$74 - $119	63%
Corvel Corporation	$82 - $256	70%
Rockport Healthcare Group	$82 - $256	70%
Prime Health	$83 - $262	71%
Sunshine State Health Plan	$85 - $112	72%
Humana	$109 - $123	93%
Plotkin Health	$168 - $220	143%
Prime Health Sheriff	$168 - $220	143%
Evolutions Healthcare Systems	$184 - $405	157%
Multiplan	$251 - $374	213%

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 $388.
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 Northside 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.