CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cambridge Health Alliance

Billing Code: 99203 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$137

about 1.2× the $118 Medicare rate · typically $62–$194

modeled estimate · not a bill or quote

What this hospital charges insurers

$31

Below the fair price — a good deal

about $106 under the fair price · 0.3× Medicare

Medicare pays $118 Fair price $137 This hospital $31 Cash price $135 Hospital's list price $135

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

One of the lower prices — 6 of 8 other MA hospitals charge more for the same procedure.

Cheapest $27 Priciest $100

Black dot = this hospital, among the 9 MA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a New patient office visit (30-44 min) is about $137 (about 1.2× the $118 Medicare rate). Cambridge Health Alliance charges insurers about $31, or about $135 in cash — below the fair price — a good deal. Located in Cambridge, MA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$66 - $74	56%
Blue Cross Blue Shieldmajor	$30 - $135	26%
Aetnamajor	$135	115%
Cignamajor	$135 - $141	115%
Humanamajor	$135	115%
Medical Mutual	$135	115%
Tufts Health Plan	$37	31%
+ 33 smaller / regional plans	$59 - $135

Government programs also on file: Medicare, Military & VA.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 135), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99203.

Insurance Before you use insurance

Call your insurance company to confirm Cambridge Health Alliance is in-network.
Ask your insurer whether prior approval is required for CPT code 99203.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Cambridge Health Alliance

Compare: New patient office visit (30-44 min) at other MA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.