CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: T J Samson Community Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $104
  • Cash Discount Price: $157
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at T J Samson Community Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.88x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.
Cash / Self-Pay
$157

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $157 (134%)
Insurance Median: $104 (88%)
Cash: $157 (134% of Medicare)
Ins. Median: $104 (88% 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 $61 - $277 52%
Devoted Mcr Adv - All Plans $61 - $83 52%
Humana $61 - $277 52%
Molina Mcaid $62 - $285 53%
Wellcare Mcaid $68 - $277 58%
Blue Cross Blue Shield $70 - $235 60%
Center Care Select - All Plans $70 - $235 60%
Signature Health - All Plans $70 60%
Wellcare Mcr Adv - All Other Plans $70 60%
Molina Mcr Adv $71 60%
Caresource - All Plans $90 - $104 77%
Molina Marketplace - All Other Plans $90 - $104 77%
UnitedHealthcare $169 144%
Phcs/Multiplan - All Plans $205 - $260 174%
First Health - All Plans $207 - $263 176%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 North Race Street, Glasgow, KY 42141
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals