CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Ochsner Medical Center Acute

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $128
Cash Discount Price: $37
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Ochsner Medical Center Acute is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.09x the Medicare baseline. Located in 1516 Jefferson Hwy, New Orleans, LA.

Cash / Self-Pay

$37

Average discount available for prompt cash payment at this facility.

Insurance Median

$128

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: $37 (31%)

Insurance Median: $128 (109%)

Cash: $37 (31% of Medicare)

Ins. Median: $128 (109% 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
Humana	$38	32%
UnitedHealthcare	$38 - $114	32%
Aetna	$39 - $90	33%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$39	33%
Healthy Blue (Healthy Louisiana)	$39	33%
Louisiana Healthcare Connections (Healthy Louisiana)	$39	33%
Medicaid / KanCare	$68 - $71	58%
First Health Network	$124	105%
Louisiana Workers' Compensation Corporation (Lwcc)	$124	105%
Mississippi Physicians Care Network	$124	105%
Healthcomp & Personify Health (Formerly Gilsbar)	$131	111%
Claritev D/B/A Multiplan/Phcs/American Life Care	$133	113%
Zelis	$133	113%
Employers Health Network (Ehn)	$141	120%
Prime Health Services Ppo	$141	120%
Usa Managed Care Network	$141	120%
Behavioral Health Systems	$149	127%
Evolutions Healthcare	$149	127%
Galaxy Health Network Ppo	$149	127%
Galaxy Health Network Wc	$149	127%
Blue Cross Blue Shield	$215 - $258	183%

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 $37.
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 Medical Center Acute 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.