CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Charlevoix Area Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $109
Cash Discount Price: $116
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Charlevoix Area Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.93x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $116 (99%)

Insurance Median: $109 (93%)

Cash: $116 (99% of Medicare)

Ins. Median: $109 (93% 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
Mclaren Health Plan	$52 - $127	44%
Meridian	$52 - $80	44%
Priority Health	$52 - $136	44%
UnitedHealthcare	$52 - $118	44%
Blue Cross Blue Shield	$53 - $126	45%
Blue Care Network	$64 - $71	54%
Hap (Health Alliance Plan)	$64 - $170	54%
Medicare (plans)	$64 - $71	54%
Michigan Amish Medical Board	$64 - $71	54%
Northern Michigan Mennonite Group	$64 - $71	54%
Aetna	$65 - $123	55%
Molina	$69 - $71	59%
Hospice Of Michigan	$82	70%
Cigna	$93 - $136	79%
Asr Physicians Care Network	$107 - $109	91%
Employee Benefits Logistics	$109 - $121	93%
Enterprise Group Planning Employee Benefit Plan	$109	93%
First Health/Coventry Health/Community Care Network	$109	93%
Medical Cost Savings Solution	$109	93%
Nomi Health	$114 - $126	97%
Provider Network Of America/Hma Group Health	$116 - $158	99%
Three Rivers Provider Network	$116	99%
Iba Health And Life Assurance Company	$125	106%
Cofinity	$126	107%
Preferred Medical Claim Solutions	$129	110%

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 $116.
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 Charlevoix Area 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.