CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Atrium Health Navicent the Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $138
  • Cash Discount Price: $147
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Atrium Health Navicent the Medical Center is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.17x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.
Cash / Self-Pay
$147

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $147 (125%)
Insurance Median: $138 (117%)
Cash: $147 (125% of Medicare)
Ins. Median: $138 (117% 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
Aetna $77 - $287 65%
Blue Cross Blue Shield $77 - $350 65%
Georgia Health Advantage $77 - $104 65%
Humana $77 - $286 65%
UnitedHealthcare $77 - $148 65%
Care Source $79 - $106 67%
Clover $79 - $106 67%
Eon Health $79 - $106 67%
Pruitt Health $81 - $104 69%
Alliant $93 - $183 79%
Ambetter / Centene $104 - $212 88%
Multiplan $107 - $333 91%
Beechstreet $132 - $387 112%
Ibg $132 - $294 112%
Novanet $132 - $333 112%
Cigna $139 - $274 118%
Three Rivers Provider Network $140 - $354 119%
Securehealth $146 - $161 124%
Kaiser $181 - $315 154%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hemlock Street, Macon, GA 31201
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals