CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Rush Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $125
  • Cash Discount Price: $176
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Rush Memorial Hospital is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.06x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.
Cash / Self-Pay
$176

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $176 (150%)
Insurance Median: $125 (106%)
Cash: $176 (150% of Medicare)
Ins. Median: $125 (106% 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
Coventry/First Health-All Plans $55 - $352 47%
Aetna $59 - $359 50%
Consumers Life Ins-All Plans $59 - $352 50%
UnitedHealthcare $59 - $313 50%
Humana $75 - $359 64%
Cigna $77 - $313 65%
Health Net $77 - $115 65%
Phcs-All Plans $77 - $313 65%
Caresource Marketplace-All Other Plans $92 - $194 78%
Blue Cross Blue Shield $119 - $286 101%
Caresource Mcr Adv $121 103%
My True Advantage - All Plans $121 103%
Today'S Option Mcr Adv-All Plans $125 106%
Viant Beech St Mcr Adv $125 106%
Encore Health Services-All Plans $133 - $383 113%
Siho-All Plans $133 - $359 113%
Multiplan-All Plans $148 - $363 126%
Sagamore-All Plans $359 305%
Community Health Alliance-All Plans $367 312%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1300 N Main St, Rushville, IN 46173
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals