CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Lost Rivers Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $163
  • Cash Discount Price: $159
  • vs. Medicare Baseline: 1.39x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Lost Rivers Medical Center is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.39x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.
Cash / Self-Pay
$159

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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: $159 (135%)
Insurance Median: $163 (139%)
Cash: $159 (135% of Medicare)
Ins. Median: $163 (139% 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
Ihcn Brightpath-All Other Plans $61 - $420 52%
Pacificsource Navigator-All Other Plans $61 - $204 52%
Tricare $61 - $122 52%
Va Pccc-All Plans $66 - $429 56%
Humana $68 - $442 58%
Prime Health Svcs-All Other Plans $68 58%
UnitedHealthcare $68 58%
Select Health Mcr Adv $81 - $442 69%
Magellan Bh Op Only - All Plans $91 77%
Womens Health Check Op/Profee Only-All Plans $100 85%
Cigna $101 - $115 86%
Blue Cross Blue Shield $110 - $442 94%
Regence/Brightpth Slhp Mcr $119 - $442 101%
Regence Blue Shield-All Other Plans $121 - $211 103%
Provider Network Of America-All Plans $122 104%
Select Health Brightpath-All Other Plans $124 - $398 105%
Aetna $156 - $202 133%
Altius Health Plan-All Plans $156 - $209 133%
First Choice-All Plans $170 - $200 145%
Ihcn Brightpath Mcr Adv $442 376%
Molina Mcr Adv-All Plans $442 376%
Pacificsource Mcr Adv $442 376%
Prime Hlth Mcr Adv $464 395%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 551 Highland Drive, Arco, ID 83213
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals