CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Rockcastle County Hospital, Inc.

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $97
  • Cash Discount Price: $109
  • vs. Medicare Baseline: 0.83x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Rockcastle County Hospital, Inc. is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.83x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$109

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $109 (93%)
Insurance Median: $97 (83%)
Cash: $109 (93% of Medicare)
Ins. Median: $97 (83% 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
Passport Hp Hmo - All Plans $27 - $186 23%
Tricare $52 44%
Blue Cross Blue Shield $68 - $140 58%
Caresource Mcr Adv-All Other Plans $70 60%
Humana $70 60%
Molina Marketplace - All Other Plans $70 60%
Molina Mcr Adv $70 60%
Signature Mcr Adv-All Plans $70 60%
Wellcare Mcr Adv-All Other Plans $70 60%
Caresource Mcaid $79 - $186 67%
Coventry Mcaid-All Plans $79 - $186 67%
Medicaid / KanCare $79 - $186 67%
Molina Mcaid $79 - $186 67%
UnitedHealthcare $79 - $186 67%
Multiplan-All Plans $85 - $158 72%
Prime Health Services-All Plans $85 - $167 72%
Integrated Hp-All Plans $89 - $166 76%
Corvel - All Plans $90 - $167 77%
Center Care-All Plans $95 - $177 81%
Cigna $97 - $180 83%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals