CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cambridge Health Alliance

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $135
  • Cash Discount Price: $135
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cambridge Health Alliance is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.15x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$135

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $135 (115%)
Insurance Median: $135 (115%)
Cash: $135 (115% of Medicare)
Ins. Median: $135 (115% 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
Blue Cross Blue Shield $30 - $135 26%
Other Tufts Health Public Plan [75002] $37 31%
Mass Bh Partnership [70098] $59 50%
Aarp [40001] $66 56%
Oxford Health [40004] $66 56%
United Medical Resource [40005] $66 56%
UnitedHealthcare $66 - $74 56%
Health Plans Inc [20002] $74 63%
Hphc [20001] $74 63%
Wc [90001] $80 68%
Mass General Brigham [50021] $86 73%
Multiplan [50010] $92 78%
Aetna $135 115%
Altus Dental [99011] $135 115%
Beacon Health Strategies [50002] $135 115%
Cbhc Uninsured Crisis Alt Payer [70097] $135 115%
Cbhc Uninsured Crisis [70096] $135 115%
Celticare [50004] $135 115%
Cigna $135 - $141 115%
Commonwealth Care Alliance Dental [99004] $135 115%
Coverage Discovery [90004] $135 115%
Delta Dental Of Ma [99007] $135 115%
Dominion National Dental [99012] $135 115%
Dph Tb Payor [85004] $135 115%
Esp Dental [99003] $135 115%
Eyemed Alt Payor [13001] $135 115%
First Health [50007] $135 115%
Global Medical Management [50024] $135 115%
Government Employee Health Association [50023] $135 115%
Guardian Dental [99013] $135 115%
Health Safety Net Dental [99002] $135 115%
Humana $135 115%
Ma Laborers Health And Welfare Fund [50022] $135 115%
Magellan Health Services [65098] $135 115%
Mass Health Dental [99001] $135 115%
Medical Mutual Of Ohio [50019] $135 115%
Medicare (plans) $135 115%
Metlife Dental [99008] $135 115%
Modern Assistance Program [30098] $135 115%
Mva [90002] $135 115%
Neighborhood Health Plan [50011] $135 115%
Other Bh Payor [50014] $135 115%
Other Commercial Payor [50015] $135 115%
Other Dental Payor [99014] $135 115%
Other Dual Eligible Payer [65004] $135 115%
Other Gov'T Alt [85006] $135 115%
Other Vision Payor [50013] $135 115%
Ri Neighborhood Health Plan [50017] $135 115%
Tricare $135 115%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals