CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Hammond Henry Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $131
Cash Discount Price: $242
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Hammond Henry Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $242. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.11x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$242

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: $242 (206%)

Insurance Median: $131 (111%)

Cash: $242 (206% 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	$38 - $217	32%
Aetna	$42 - $414	36%
Health Alliance Mcare Adv	$42 - $241	36%
UnitedHealthcare	$42 - $241	36%
Humana	$43 - $373	37%
Cigna	$49 - $319	42%
Ambetter / Centene	$64 - $290	54%
Wellmark Of Ia-All Plans	$73 - $207	62%
Blue Cross Blue Shield	$80 - $414	68%
Quad City Community Hc-All Plans	$82 - $331	70%
Multiplan Phcs Adult	$90 - $373	77%
Multiplan Phcs Pediatric	$90 - $373	77%
Health Alliance-All Other Plans	$95 - $310	81%
Springfield Armory-All Plans	$95 - $269	81%
Multiplan Pponext	$99 - $331	84%
Multiplan Integrated Hp	$110 - $310	94%
Osf Direct Access Network-All Plans	$117 - $331	100%
Multiplan-All Other Plans	$124 - $352	105%
Corvel-All Plans	$131 - $373	111%
Healthsmart Adult-All Other Plans	$131 - $373	111%
Healthsmart Pediatric	$131 - $373	111%
Hfn-All Plans	$131 - $373	111%
Multiplan Beech Street	$131 - $373	111%
Usa Mco-All Plans	$131 - $373	111%
Meridian Health Plan-All Plans	$269 - $414	229%

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 $242.
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 Hammond Henry 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.