CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Henry County Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $223
Cash Discount Price: $274
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Henry County Memorial Hospital is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $274. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.90x the Medicare baseline. Located in 1000 N 16Th St, New Castle, IN.

Cash / Self-Pay

$274

Average discount available for prompt cash payment at this facility.

Insurance Median

$223

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: $274 (233%)

Insurance Median: $223 (190%)

Cash: $274 (233% of Medicare)

Ins. Median: $223 (190% 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
Aetna	$59 - $672	50%
UnitedHealthcare	$59 - $644	50%
Blue Cross Blue Shield	$68 - $791	58%
Caresource Hip	$68	58%
Humana	$68 - $696	58%
Caresource Mcr Adv	$69	59%
Cigna	$77 - $538	65%
Caresource Marketplace-All Other Plans	$92 - $129	78%
Caresource Just4Me	$102 - $170	87%
Caresource Mcaid	$105 - $815	89%
Encore Workers Comp-All Plans	$133 - $751	113%
Health Alliance-All Plans	$232 - $672	197%
Workers Comp - All Plans	$246 - $712	209%

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 $274.
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 Henry County 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.