CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cox Medical Centers

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $100
Cash Discount Price: $61
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cox Medical Centers is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.85x the Medicare baseline. Located in 3801 South National Avenue, Springfield, MO.

Cash / Self-Pay

$61

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $61 (52%)

Insurance Median: $100 (85%)

Cash: $61 (52% of Medicare)

Ins. Median: $100 (85% 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
Cox Healthplans	$70	60%
Health Net Federal Services	$70	60%
Humana	$70	60%
Medrisk Llc	$70	60%
UnitedHealthcare	$70	60%
Blue Cross Blue Shield	$71	60%
Allwell	$72	61%
Devoted	$74	63%
Provider Partners Health Plan	$74	63%
Texas Co Memorial Hospital	$75	64%
Bjc Health Solutions	$81	69%
Parkcrest Dental Group	$99	84%
Coastal Energy Corporation	$100	85%
Heart Of America Beverage Company	$102	87%
Loren Cook	$104	88%
Springfieldgreene Co Library	$106	90%
Src Holdings Corporation	$107	91%
Ozark Anesthesia Assoc. Inc	$108	92%
Justice Furniture And Bedding Co	$111	94%
Missouri Affiliated School Consortium (Masc)	$111	94%
The Durham Company	$111	94%
Ozark County	$112	95%
Ozarks Cocacola	$113	96%
Flora Farms	$115	98%
Advanced Concrete Technology	$116	99%

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 $61.
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 Cox Medical Centers 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.