CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Medstar Saint Mary's Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $195
Cash Discount Price: $191
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Medstar Saint Mary's Hospital is $195. 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 1.66x the Medicare baseline. Located in 25500 Point Lookout Road, Leonardtown, MD.

Cash / Self-Pay

$191

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $195 (166%)

Cash: $191 (162% of Medicare)

Ins. Median: $195 (166% 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	$195	166%
Amerigroup	$195	166%
Amerihealth Caritas District Of Columbia	$195	166%
Carefirst Advantage Inc	$195	166%
Carefirst Blue Choice Inc	$195	166%
Cigna	$195	166%
First Health	$195	166%
Hscsn	$195	166%
Humana	$195	166%
Kaiser Permanente	$195	166%
Magellan Behavioral Health Inc	$195	166%
Mamsi	$195	166%
Medstar Family Choice	$195	166%
Medstar Family Choice Inc	$195	166%
Ncppo Healthlink Ppo	$195	166%
Pfc	$195	166%
Private Healthcare Systems (Phcs)	$195	166%
Tricare	$195	166%
United Behavioral Health Inc	$195	166%
UnitedHealthcare	$195	166%

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 $191.
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 Medstar Saint Mary's Hospital 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.