CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: HCA Florida South Shore Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $267
Cash Discount Price: $1,765
vs. Medicare Baseline: 2.27x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at HCA Florida South Shore Hospital is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,765. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.27x the Medicare baseline. Located in 4016 Sun City Center Blvd, Sun City Center, FL.

Cash / Self-Pay

$1,765

Average discount available for prompt cash payment at this facility.

Insurance Median

$267

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: $1,765 (1501%)

Insurance Median: $267 (227%)

Cash: $1,765 (1501% of Medicare)

Ins. Median: $267 (227% 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 227% of the Medicare baseline (a markup of 127%). 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
Corvel Corporation	$82 - $256	70%
Rockport Healthcare Group	$82 - $256	70%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$83	71%
Prime Health	$83 - $262	71%
Blue Cross Blue Shield	$90 - $369	77%
Aetna	$122 - $530	104%
Access 2 Healthcare Physicians Freedom Health	$127	108%
Access 2 Healthcare Physicians Optimum	$127	108%
Freedom Health Care	$138	117%
Optimum Healthcare	$138	117%
Truli	$145 - $215	123%
Simply Healthcare	$272	231%
United	$290 - $794	247%
Cigna	$318	270%
Molina	$335 - $477	285%
Sunshine State Health Plan	$450	383%
Humana	$494	420%
Plotkin Health	$883	751%
Prime Health Sheriff	$883	751%
Evolutions Healthcare Systems	$971 - $1,624	826%
Multiplan	$1,324 - $1,501	1126%

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 $1,765.
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 South Shore 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.