CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Thomas H Boyd Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $91
Cash Discount Price: $143
vs. Medicare Baseline: 0.77x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Thomas H Boyd Memorial Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $143. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.77x the Medicare baseline. Located in 800 School St, Carrollton, IL.

Cash / Self-Pay

$143

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $143 (122%)

Insurance Median: $91 (77%)

Cash: $143 (122% of Medicare)

Ins. Median: $91 (77% 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
UnitedHealthcare	$62 - $93	53%
Aetna	$71 - $134	60%
Blue Cross Blue Shield	$71 - $134	60%
Meridian Hp Mcaid-All Plans	$71	60%
Molina Mcaid-All Plans	$71	60%
Ambetter / Centene	$73 - $119	62%
Healthlink Hmo	$75 - $136	64%
Healthlink Il Only	$75 - $136	64%
Cigna	$80 - $128	68%
Healthlink Ppo-All Other Plans	$81 - $154	69%
Health Alliance-All Other Plans	$88 - $110	75%
Health Alliance Mcr Adv	$89 - $91	76%
Wellcare Mcr Adv-All Plans	$91	77%
Humana	$92	78%
Multiplan-All Plans	$134 - $160	114%
Hfn Zelis-All Plans	$162 - $163	138%

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 $143.
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 Thomas H Boyd Memorial 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.