CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Pine Rest Christian Mental Health Services

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $92
Cash Discount Price: $151
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Pine Rest Christian Mental Health Services is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.78x the Medicare baseline. Located in 300 - 68Th Street, Se, Grand Rapids, MI.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $151 (128%)

Insurance Median: $92 (78%)

Cash: $151 (128% of Medicare)

Ins. Median: $92 (78% 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
Golden Rule [1131]	$46 - $90	39%
Healthscope Benefits [1140]	$46 - $90	39%
Ubh [1167]	$46 - $90	39%
UnitedHealthcare	$46 - $90	39%
Aetna	$52 - $183	44%
Blue Cross Blue Shield	$52 - $122	44%
Medicaid / KanCare	$52 - $71	44%
Champva [1117]	$68 - $108	58%
Humana	$68 - $146	58%
Medicare (plans)	$68 - $108	58%
Molina [1156]	$68 - $108	58%
Tricare	$68 - $108	58%
Veterans Administration [1174]	$68 - $108	58%
Blue Care Network [1000]	$100 - $118	85%
University Of Michigan Health Plan Comm [1159]	$101 - $119	86%
University Of Michigan Health Plan [1205]	$101 - $119	86%
Asr Physicians Care Health Plan [1160]	$108 - $127	92%
Hap Ppo/Health Alliance Plan [1134]	$108 - $127	92%
Mclaren Health Plan [1149]	$108	92%
Cigna	$134	114%
Priority Health [1300]	$142	121%
Compsych [1122]	$148 - $188	126%
Cofinity [1120]	$156 - $183	133%
Geha [1129]	$156 - $183	133%
Meritain Health Plan [1153]	$156 - $183	133%
Behavioral Health Systems [1115]	$171 - $201	145%
Network 180 [3530]	$182	155%

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 $151.
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 Pine Rest Christian Mental Health Services 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.