CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Helen Newberry Joy Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $229
  • Cash Discount Price: $149
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Helen Newberry Joy Hospital is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.95x the Medicare baseline. Located in 502 W Harrie St, Newberry, MI.
Cash / Self-Pay
$149

Average discount available for prompt cash payment at this facility.

Insurance Median
$229

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: $149 (127%)
Insurance Median: $229 (195%)
Cash: $149 (127% of Medicare)
Ins. Median: $229 (195% 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
Mi Wc - All Plans $46 - $235 39%
Aetna $65 - $349 55%
Uphg Tpa - All Plans $65 - $331 55%
First Health - All Plans $68 - $349 58%
Ppom/Cofinity - All Plans $68 - $349 58%
Cigna $70 - $356 60%
Health Alliance - All Plans $70 - $356 60%
Healtheos - All Plans $70 - $356 60%
Priority Health - All Plans $70 - $356 60%
UnitedHealthcare $70 - $356 60%
Vital Core - All Plans $70 - $357 60%
Blue Cross Blue Shield $71 - $363 60%
Uphp Mcaid - All Plans $229 195%
Va - All Plans $253 215%
Humana $321 273%
Mi Health Link - All Plans $321 273%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 502 W Harrie St, Newberry, MI 49868
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals