CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Ochsner Lafayette General Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $45
Cash Discount Price: $34
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Ochsner Lafayette General Medical Center is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.38x the Medicare baseline. Located in 1214 Coolidge Avenue, Lafayette, LA.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $34 (29%)

Insurance Median: $45 (38%)

Cash: $34 (29% of Medicare)

Ins. Median: $45 (38% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$38 - $88	32%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$38	32%
Healthy Blue (Healthy Louisiana)	$38	32%
Humana	$38	32%
Louisiana Healthcare Connections (Healthy Louisiana)	$38	32%
UnitedHealthcare	$38 - $52	32%
Verity Commercial And First Choice Network	$87	74%
Zelis	$97	83%
Blue Cross Blue Shield	$262 - $287	223%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $34.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ochsner Lafayette General Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.