CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mercy Hospital Jefferson

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$118

about 1.0× the $118 Medicare rate · typically $70–$210

modeled estimate · not a bill or quote

What this hospital charges insurers

$77

Below the fair price — a good deal

about $41 under the fair price · 0.7× Medicare

Medicare pays $118 Fair price $118 This hospital $77 Cash price $83 Hospital's list price $127

How we calculate the fair BaseRate →

How this hospital compares to other MO hospitals

Highest price of the 9 MO hospitals we have prices for — worth calling around.

Cheapest $56 Priciest $77

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

A fair price for a New patient office visit (30-44 min) is about $118 (about 1.0× the $118 Medicare rate). Mercy Hospital Jefferson charges insurers about $77, or about $83 in cash — below the fair price — a good deal. Located in Crystal City, MO.

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	$77 - $171	65%
Blue Cross Blue Shieldmajor	$51 - $1,901	43%
Aetnamajor	$16 - $117	14%
Cignamajor	$49 - $274	42%
Humanamajor	$77 - $80	65%
Ambetter (Centene)	$29 - $90	25%
HealthLink	$42 - $241	36%
Medica	$28 - $87	24%
+ 38 smaller / regional plans	$29 - $234

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

Excludes 6 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 83), 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 Mercy Hospital Jefferson 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 Mercy Hospital Jefferson

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

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