CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Valor Health

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $131
Cash Discount Price: $264
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Valor Health is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $264. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.11x the Medicare baseline. Located in 1202 East Locust Street, Emmett, ID.

Cash / Self-Pay

$264

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $264 (225%)

Insurance Median: $131 (111%)

Cash: $264 (225% of Medicare)

Ins. Median: $131 (111% 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
Tricare	$32 - $127	27%
Aetna	$33 - $232	28%
Blue Cross Blue Shield	$33 - $300	28%
Blue Shield Mcr Adv	$33 - $131	28%
Humana	$33 - $272	28%
Molina Mcr Adv - All Plans	$33 - $131	28%
Regence Bs Triwest - All Plans	$33 - $131	28%
UnitedHealthcare	$33 - $257	28%
Pacificsource Mcr Adv	$35 - $137	30%
Moda Health - All Plans	$66 - $264	56%
Pacificsource Comm - All Other Plans	$66 - $264	56%
Select Health Comm - All Other Plans	$66 - $264	56%
Select Health Mcr Adv	$92 - $139	78%
Blue Shield Comm - All Other Plans	$121	103%
Cigna	$133 - $149	113%

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 $264.
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 Valor Health 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.