CMS Price Transparency Data
New patient office visit (30-44 min)
Facility: Mercy Hospital Washington
Billing Code: 99203 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99203
- Insurance Median: $108
- Cash Discount Price: $159
- vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercy Hospital Washington is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.92x the Medicare baseline. Located in 901 East 5Th Street, Washington, MO.
Cash / Self-Pay
$159
Average discount available for prompt cash payment at this facility.
Insurance Median
$108
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: $159 (135%)
Insurance Median: $108 (92%)
Cash: $159 (135% of Medicare)
Ins. Median: $108 (92% 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 |
|---|---|---|
| Medicaid / KanCare | $14 - $75 | 12% |
| Aetna | $31 - $97 | 26% |
| Medica Contracted [320239] | $54 - $239 | 46% |
| Ambetter / Centene | $56 - $75 | 48% |
| Home State Health Plan Contracted [320187] | $56 - $75 | 48% |
| Novasys Contracted [320285] | $56 - $75 | 48% |
| American Health Advantage Of Mo Mcr [10473] | $75 | 64% |
| Blue Cross Blue Shield | $75 - $1,901 | 64% |
| Cherokee Nation Health Serv Contracted [320066] | $75 | 64% |
| Cross Timbers Hospice [20098] | $75 | 64% |
| Dept Of Veteran Affairs Contracted [320106] | $75 | 64% |
| Elara Caring Aspire Hospice Contracted [320433] | $75 | 64% |
| Elara Caring Aspire Hospice [20433] | $75 | 64% |
| Globalhealth Contracted [320145] | $75 | 64% |
| Halo Hcr Inc Hospice Contracted [320432] | $75 | 64% |
| Halo Hcr Inc Hospice [20432] | $75 | 64% |
| Humana | $75 - $78 | 64% |
| Kindful Hospice Contracted [320434] | $75 | 64% |
| Kindful Hospice [20434] | $75 | 64% |
| Medicare (plans) | $75 - $278 | 64% |
| Mercy Hospice Okc [20252] | $75 | 64% |
| Pace Of The Ozarks Contracted [320518] | $75 | 64% |
| Qual Choice Contracted [320325] | $75 | 64% |
| Tricare | $75 | 64% |
| UnitedHealthcare | $75 - $142 | 64% |
| Cigna | $79 - $288 | 67% |
| Aither Health Contracted [320449] | $81 - $292 | 69% |
| Aither Health [20449] | $81 - $292 | 69% |
| Auxiant Contracted [320462] | $81 - $292 | 69% |
| Ebms Contracted [320493] | $81 - $292 | 69% |
| Edison Health Solutions Contracted [320502] | $81 - $292 | 69% |
| Healthlink Contracted [320179] | $81 - $292 | 69% |
| Imagine 360 Contracted [320494] | $81 - $292 | 69% |
| Mercy Benefit Admin Contracted [320251] | $81 - $292 | 69% |
| Mercy Benefit Admin [20251] | $81 - $292 | 69% |
| Reflect Health Contracted [320492] | $81 - $292 | 69% |
| Show-Me Health Administrators Contracted [320483] | $81 - $298 | 69% |
| Yuzu Health Contracted [320521] | $81 - $292 | 69% |
| Provider Partners Health Plans Contracted [320450] | $82 | 70% |
| Healthscope Contracted [320182] | $94 | 80% |
| Centivo Contracted [320505] | $125 | 106% |
| Health Choices Contracted [320448] | $125 - $167 | 106% |
| Health Choices [20448] | $125 - $167 | 106% |
| Medical Associates Health Contracted [320444] | $125 - $167 | 106% |
| Preferred Health Plan Contracted [320522] | $133 | 113% |
| Federal Medical Center Contracted [320127] | $135 - $181 | 115% |
| Insurance System Inc Contracted [320465] | $135 - $181 | 115% |
| Point C Contracted [320238] | $135 - $181 | 115% |
| Tri State Healthcare Coalition Contracted [320379] | $135 - $181 | 115% |
| United Medical Resources Contracted [320454] | $142 | 121% |
| First Health Contracted [320128] | $146 - $197 | 124% |
| Mercy Mgd Behavioral Health Contracted [320259] | $146 - $195 | 124% |
| Multiplan Contracted [320270] | $146 - $208 | 124% |
| Private Health Care Systems Contracted [320320] | $146 - $195 | 124% |
| Workers Comp [20426] | $156 - $222 | 133% |
| Hope Trust Contracted [320488] | $171 | 145% |