CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Piedmont Augusta Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $169
Cash Discount Price: $121
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Piedmont Augusta Hospital is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.44x the Medicare baseline. Located in 1350 Walton Way, Augusta, GA.

Cash / Self-Pay

$121

Average discount available for prompt cash payment at this facility.

Insurance Median

$169

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: $121 (103%)

Insurance Median: $169 (144%)

Cash: $121 (103% of Medicare)

Ins. Median: $169 (144% 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
Blue Cross Blue Shield	$65 - $136	55%
Absolute Total Care [20109]	$85	72%
Medicaid / KanCare	$95	81%
Alliant Health Plans Of Georgia [10952]	$149	127%
Alliant Solocare [11101]	$149	127%
UnitedHealthcare	$158 - $244	134%
Medcost [10966]	$161	137%
Multiplan [10600]	$177	151%
Phcs [10601]	$177	151%
Industry Buying Group [10840]	$262	223%
Aetna	$294	250%
Kaiser [10500]	$298	253%
First Health [10303]	$343	292%
Novanet [10819]	$363	309%
Cigna	$403	343%

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 $121.
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 Piedmont Augusta 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.