CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Athur M Blank Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $292
Cash Discount Price: $492
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Athur M Blank Hospital is $292. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $492. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.48x the Medicare baseline. Located in 2220 North Druid Hills Road Ne, Atlanta, GA.

Cash / Self-Pay

$492

Average discount available for prompt cash payment at this facility.

Insurance Median

$292

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: $492 (418%)

Insurance Median: $292 (248%)

Cash: $492 (418% of Medicare)

Ins. Median: $292 (248% 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 248% of the Medicare baseline (a markup of 148%). 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
Peachstate [43]	$123 - $297	105%
Caresource [61]	$126 - $306	107%
Amerigroup [102]	$132 - $320	112%
Blue Cross Blue Shield	$190 - $679	162%
Cigna	$190 - $460	162%
United [5]	$190 - $462	162%
Ambetter / Centene	$192 - $466	163%
Oscar [228]	$192 - $466	163%
Aetna	$193 - $468	164%
Caresource Marketplace Bronze/Silver/Gold [60]	$195 - $473	166%
Kaiser [6]	$195 - $474	166%
Sidecar Health [236]	$198 - $480	168%
Coventry [9]	$201 - $488	171%
Direct Employer Agreements [72]	$201 - $592	171%
First Health [74]	$215 - $522	183%
Northeast Georgia Heatlh System [808]	$215 - $522	183%
Veracity Benefits [809]	$215 - $522	183%
Phcs [93]	$244 - $592	208%
Secure Health [340]	$244 - $592	208%
Beech Street [71]	$258 - $626	219%
Multiplan [92]	$281 - $682	239%
Novanet [41]	$287 - $696	244%

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 $492.
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 Athur M Blank 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.