CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Grady Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $110
  • Cash Discount Price: $562
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Grady Memorial Hospital is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $562. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.94x the Medicare baseline. Located in 80 Jesse Hill, Jr Drive Se, Atlanta, GA.
Cash / Self-Pay
$562

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $562 (478%)
Insurance Median: $110 (94%)
Cash: $562 (478% of Medicare)
Ins. Median: $110 (94% 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.

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
Peach State $56 - $109 48%
Amerigroup $77 - $109 65%
Caresource $77 - $175 65%
Aetna $80 - $250 68%
Ambetter / Centene $80 - $110 68%
Blue Cross Blue Shield $80 - $450 68%
Cigna $80 - $332 68%
Humana $80 - $110 68%
Kaiser $80 - $426 68%
Medicare (plans) $80 - $110 68%
UnitedHealthcare $80 - $405 68%
Vaccn $80 - $110 68%
Wellcare $80 - $110 68%
Clear Spring Health $84 - $115 71%
Clover $84 - $115 71%
Usp Naphcare $88 - $337 75%
Oscar Health $113 - $365 96%
Multiplan $433 368%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 80 Jesse Hill, Jr Drive Se, Atlanta, GA 30303
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals