CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$100

about 0.8× the $118 Medicare rate · typically $80–$155

modeled estimate · not a bill or quote

What this hospital charges insurers

$102

About the fair price

about $2 over the fair price · 0.9× Medicare

Medicare pays $118 Fair price $100 This hospital $102 Cash price $207 Hospital's list price $207

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

Highest price of the 9 IN hospitals we have prices for — worth calling around.

Cheapest $45 Priciest $102

Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.

A fair price for a New patient office visit (30-44 min) is about $100 (about 0.8× the $118 Medicare rate). Saint Joseph Regional Medical Center - Plymouth charges insurers about $102, or about $207 in cash — about the fair price. Located in Plymouth, IN.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$66 - $156	56%
Blue Cross Blue Shieldmajor	$66 - $129	56%
Aetnamajor	$66 - $145	56%
Cignamajor	$66 - $164	56%
Humanamajor	$66 - $108	56%
Kaiser Permanentemajor	$124 - $129	105%
Ambetter (Centene)	$75 - $102	64%
CareSource	$88 - $144	75%
Clover Health	$66 - $108	56%
GEHA	$111 - $156	94%
Health Net	$68 - $175	58%
HealthPartners	$75 - $102	64%
Meridian	$66 - $108	56%
Molina	$75 - $102	64%
Paramount	$75 - $102	64%
Presbyterian	$66 - $108	56%
Tufts Health Plan	$75 - $102	64%
WellMed	$66 - $108	56%
WellSense	$75 - $102	64%
+ 347 smaller / regional plans	$66 - $238

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 10 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 207), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99203.

Insurance Before you use insurance

Call your insurance company to confirm Saint Joseph Regional Medical Center - Plymouth is in-network.
Ask your insurer whether prior approval is required for CPT code 99203.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Saint Joseph Regional Medical Center - Plymouth

Compare: New patient office visit (30-44 min) at other IN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.