CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Fayette County Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $149
  • Cash Discount Price: $198
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Fayette County Hospital is $149. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.27x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.
Cash / Self-Pay
$198

Average discount available for prompt cash payment at this facility.

Insurance Median
$149

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: $198 (168%)
Insurance Median: $149 (127%)
Cash: $198 (168% of Medicare)
Ins. Median: $149 (127% 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
Aetna $59 - $166 50%
Health Alliance Mcare $68 - $300 58%
Healthlink Mcr Adv $68 - $300 58%
Humana $68 - $300 58%
Blue Cross Blue Shield $71 - $202 60%
Illinicare - All Plans $71 60%
Medicaid / KanCare $71 60%
Meridian-All Plans $71 60%
Cigna $93 - $181 79%
Coventry/Ghp-All Plans $99 - $157 84%
Multiplan - All Plans $136 - $205 116%
UnitedHealthcare $137 - $273 117%
Healthlink Hmo $142 - $283 121%
Healthlink Ppo - All Other Plans $142 - $283 121%
Health Alliance - All Other Plans $147 - $199 125%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 650 W Taylor St, Vandalia, IL 62471
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals