CMS Price Transparency Data
New patient office visit (30-44 min)
Facility: Claiborne Memorial Medical Center
Billing Code: 99203 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99203
- Insurance Median: $143
- Cash Discount Price: $191
- vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Claiborne Memorial Medical Center is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.22x the Medicare baseline. Located in 620 East College Street, Homer, LA.
Cash / Self-Pay
$191
Average discount available for prompt cash payment at this facility.
Insurance Median
$143
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: $191 (162%)
Insurance Median: $143 (122%)
Cash: $191 (162% of Medicare)
Ins. Median: $143 (122% 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.
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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 - $124 | 32% |
| Amerihealth Caritas La | $38 - $82 | 32% |
| Community Health Solution | $38 - $82 | 32% |
| Correctcare Intergrated | $38 - $82 | 32% |
| Healthy Blue | $38 - $82 | 32% |
| Humana | $38 - $191 | 32% |
| Louisiana Hc Connections | $38 - $82 | 32% |
| Magellan Services | $38 - $82 | 32% |
| Medicaid / KanCare | $38 - $82 | 32% |
| UnitedHealthcare | $38 - $82 | 32% |
| Arcadian Community Mcr Hm | $75 | 64% |
| Blue Cross Blue Shield | $75 - $238 | 64% |
| Champus | $75 | 64% |
| Champva | $75 | 64% |
| Cigna | $75 - $143 | 64% |
| Healthy Blue Dual Adv | $75 | 64% |
| Kaiser Foundation Health | $75 | 64% |
| Medicare (plans) | $75 | 64% |
| Peoples Health Network | $75 | 64% |
| Pyramid Claims Mcr Hmo | $75 | 64% |
| Sterling Connect 2 | $75 | 64% |
| Sterling Premier Mc Hmo | $75 | 64% |
| Superior Health Mcr Hmo | $75 | 64% |
| Tenet Mcr Hmo | $75 | 64% |
| Tricare | $75 | 64% |
| United Hc Mcr Hmo | $75 | 64% |
| Universal Hc Mcr Hmo | $75 | 64% |
| Us Dept Of Labor | $75 | 64% |
| Vantage Health Mcr Hmo | $75 | 64% |
| Windsor Sterling Mcr Hmo | $75 | 64% |
| Wps Mvh Vapc3 | $75 | 64% |
| Commercial Insurance | $76 - $191 | 65% |
| Meritain Health | $76 - $124 | 65% |
| Vantage Health Plan Inc | $80 - $93 | 68% |
| Coventry Healthcare | $115 | 98% |
| Sedgwick Claims Mgmt Serv | $122 - $172 | 104% |
| Workman'S Comp | $122 - $172 | 104% |
| Geha | $134 | 114% |
| Health Plus Of La | $134 - $143 | 114% |
| Apwu Healthplan | $143 | 122% |
| Great West Healthcare | $143 | 122% |
| Phcs | $153 | 130% |
| Ppo Plus | $153 | 130% |
| Aarp | $191 | 162% |
| Accordia National | $191 | 162% |
| Aflac | $191 | 162% |
| Alameda Alliance Forhealt | $191 | 162% |
| American Pioneer | $191 | 162% |
| Benefit Management | $191 | 162% |
| Benesys Inc | $191 | 162% |
| Business Guarantor | $191 | 162% |
| Chubb | $191 | 162% |
| Commercial Sr. Care | $191 | 162% |
| Employee Benefit Services | $191 | 162% |
| Family Life Insurance Co | $191 | 162% |
| Farm Bureau Insurance | $191 | 162% |
| Fiserv Health Benefit | $191 | 162% |
| Gmp | $191 | 162% |
| Group And Pension Admin | $191 | 162% |
| Group Resources | $191 | 162% |
| Haik Minvielle And Grubbs | $191 | 162% |
| Harrington Benefit Svs | $191 | 162% |
| Health Design Plus | $191 | 162% |
| Health Plan | $191 | 162% |
| Healthscope Benefits | $191 | 162% |
| Insurance Management Admi | $191 | 162% |
| Jefferson National | $191 | 162% |
| John Alden Health Ins | $191 | 162% |
| John Hancock | $191 | 162% |
| Liberty Mutual | $191 | 162% |
| Mailhandlers Benefit Plan | $191 | 162% |
| Manhattan Life Ins Co | $191 | 162% |
| Mega Life And Health | $191 | 162% |
| Msa Careguard | $191 | 162% |
| Mutual Of Omaha | $191 | 162% |
| Nalc Health Benefit Plan | $191 | 162% |
| Naphcare Inc. | $191 | 162% |
| New Era Life Ins Co | $191 | 162% |
| Physicians Mutual | $191 | 162% |
| Principal Financial Group | $191 | 162% |
| Prudential Healthcare | $191 | 162% |
| Self Pay | $191 | 162% |
| State Farm | $191 | 162% |
| State Farm Insurance | $191 | 162% |
| State Mutual Insurance Co | $191 | 162% |
| Sterling Investors Life | $191 | 162% |
| Tower Life | $191 | 162% |
| Transamerica Premier Ins | $191 | 162% |
| United American | $191 | 162% |
| United Comm Travelers | $191 | 162% |
| United Teachers | $191 | 162% |
| Usable Administrator | $191 | 162% |
| Visn 16 Cfu | $191 | 162% |
| Wausau Benefits | $191 | 162% |
| Webtpa | $191 | 162% |
| Wells Fargo | $191 | 162% |
| Woodmen Of The World | $191 | 162% |