New patient office visit (30-44 min)
Facility: Mercy Hospital Columbus
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $178
- Cash Discount Price: $151
- vs. Medicare Baseline: 1.51x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $58 - $169 | 49% |
| Medicare (plans) | $78 - $176 | 66% |
| Humana | $98 - $221 | 83% |
| Insurance System Inc Contracted [320465] | $100 | 85% |
| Health Systems Inc Contracted [320174] | $100 | 85% |
| Administrative Payor Contracted [320005] | $105 | 89% |
| Blue Cross Blue Shield | $125 - $169 | 106% |
| Cigna | $169 | 144% |
| Provider Partners Health Plans Contracted [320450] | $169 | 144% |
| Cross Timbers Hospice [20098] | $169 | 144% |
| Qual Choice Contracted [320325] | $169 | 144% |
| Elara Caring Aspire Hospice [20433] | $169 | 144% |
| Mercy Mgd Behavioral Health Contracted [320259] | $169 | 144% |
| Mercy Hospice Okc [20252] | $169 | 144% |
| Centurion Of Missouri [20459] | $169 | 144% |
| Dept Of Veteran Affairs Contracted [320106] | $169 | 144% |
| Halo Hcr Inc Hospice [20432] | $169 | 144% |
| Medical Associates Health Contracted [320444] | $169 | 144% |
| Aetna | $169 - $210 | 144% |
| Pace Of The Ozarks Contracted [320518] | $169 | 144% |
| Globalhealth Contracted [320145] | $169 | 144% |
| Novasys Contracted [320285] | $169 | 144% |
| Halo Hcr Inc Hospice Contracted [320432] | $169 | 144% |
| Home State Health Plan Contracted [320187] | $169 | 144% |
| Kindful Hospice [20434] | $169 | 144% |
| Ambetter / Centene | $169 | 144% |
| Cherokee Nation Health Serv Contracted [320066] | $169 | 144% |
| UnitedHealthcare | $169 - $193 | 144% |
| Indian Health Service Contracted [320198] | $169 | 144% |
| Kindful Hospice Contracted [320434] | $169 | 144% |
| Tricare | $170 | 145% |
| Healthscope Contracted [320182] | $180 | 153% |
| Workers Comp [20426] | $186 - $198 | 158% |
| United Medical Resources Contracted [320454] | $193 - $221 | 164% |
| Medica Contracted [320239] | $209 | 178% |
| Usa Managed Care Org Contracted [320429] | $210 | 179% |
| American Healthcare Alliance Contracted [320020] | $210 | 179% |
| Federal Medical Center Contracted [320127] | $210 | 179% |
| First Health Contracted [320128] | $210 | 179% |
| Mercy Benefit Admin Contracted [320251] | $210 - $221 | 179% |
| Preferred Health Plan Contracted [320522] | $210 | 179% |
| Healthlink Contracted [320179] | $210 - $221 | 179% |
| Private Health Care Systems Contracted [320320] | $221 | 188% |
| Ebms Contracted [320493] | $221 | 188% |
| Yuzu Health Contracted [320521] | $221 | 188% |
| Auxiant Contracted [320462] | $221 | 188% |
| 90 Degree Benefits Contracted [320436] | $221 | 188% |
| Benefit Management Contracted [320052] | $221 | 188% |
| Imagine 360 Contracted [320494] | $221 | 188% |
| Reflect Health Contracted [320492] | $221 | 188% |
| Edison Health Solutions Contracted [320502] | $221 | 188% |
| Point C Contracted [320238] | $221 | 188% |
| Show-Me Health Administrators Contracted [320483] | $221 | 188% |
| Ppo Plus Contracted [320310] | $221 | 188% |
| Aither Health Contracted [320449] | $221 | 188% |
Consumer Guidance & Cost Commentary
For this office visit service, the facility's cash price of $151.00 is lower than the median negotiated rate of $178.00 and the gross charge of $233.00. While many commercial payers have negotiated rates ranging from $169 to $221, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds $151.00. It is important to note that the facility's cash rate is significantly lower than the gross charges, which often leads patients to believe they are receiving a substantial discount; however, the true benchmark for fair pricing is the Medicare rate of $117.57, which serves as the objective baseline for cost.
To ensure you are not overcharged, always request a full itemized bill before paying, as summary bills can obscure individual line items and potential errors. If you choose to use insurance, be aware that administrative processing costs often inflate the baseline price by 20% to 40%, meaning the negotiated rate may be higher than the cash price despite being "in-network." Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront, bypassing the costly insurance claims cycle.