CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Jay Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $95
Cash Discount Price: $45
vs. Medicare Baseline: 0.81x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Jay Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.81x the Medicare baseline. Located in 14114 Alabama St, Jay, FL.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $45 (38%)

Insurance Median: $95 (81%)

Cash: $45 (38% of Medicare)

Ins. Median: $95 (81% 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
Aetna	$65 - $167	55%
Bc Fl	$65	55%
Humana	$65	55%
UnitedHealthcare	$65 - $74	55%
Wellcare	$65	55%
Fl Blue	$71 - $140	60%
Cha Health Plan	$86	73%
Simply Healthcare Healthy Kids	$86	73%
Hospice Emerald Coast	$148	126%
Hospice Regency	$148	126%
Hospice Vitas	$148	126%
Cigna	$165 - $297	140%
Private Healthcare	$193	164%
First Health	$211	179%
Wc Corvel	$212 - $282	180%
Multiplan	$264	225%

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 $45.
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 Jay 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.