CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mercy Hospital Southeast

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $86
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 0.73x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercy Hospital Southeast is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.73x the Medicare baseline. Located in 1701 Lacey St, Cape Girardeau, MO.
Cash / Self-Pay
$83

Average discount available for prompt cash payment at this facility.

Insurance Median
$86

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: $83 (71%)
Insurance Median: $86 (73%)
Cash: $83 (71% of Medicare)
Ins. Median: $86 (73% 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 $16 - $53 14%
Aetna $23 - $228 20%
Blue Cross Blue Shield $51 - $351 43%
First Health Contracted [320128] $69 - $228 59%
Health Alliance Contracted [320164] $70 - $231 60%
Aither Health Contracted [320449] $73 - $242 62%
Edison Health Solutions Contracted [320502] $73 - $242 62%
Healthlink Contracted [320179] $73 - $278 62%
Mercy Benefit Admin Contracted [320251] $73 - $242 62%
Mercy Benefit Admin [20251] $73 - $242 62%
Yuzu Health Contracted [320521] $73 - $242 62%
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%
Halo Hcr Inc Hospice Contracted [320432] $75 64%
Halo Hcr Inc Hospice [20432] $75 64%
Humana $75 - $303 64%
Kindful Hospice Contracted [320434] $75 64%
Kindful Hospice [20434] $75 64%
Medicare (plans) $75 - $80 64%
Mercy Hospice Okc [20252] $75 64%
Pace Of The Ozarks Contracted [320518] $75 64%
Tricare $75 64%
UnitedHealthcare $75 - $182 64%
Cigna $76 - $14,290 65%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $77 65%
Workers Comp [20426] $81 - $285 69%
Multiplan Contracted [320270] $86 - $285 73%
Private Health Care Systems Contracted [320320] $86 - $285 73%
Provider Partners Health Plans Contracted [320450] $86 73%
Ambetter / Centene $99 84%
Home State Health Plan Contracted [320187] $99 84%
Consociate Consolidated Health Contracted [320490] $104 - $168 88%
Centivo Contracted [320505] $125 106%
Auxiant Contracted [320462] $129 - $153 110%
Ebms Contracted [320493] $129 110%
Imagine 360 Contracted [320494] $129 110%
Preferred Health Plan Contracted [320522] $133 113%
Reflect Health Contracted [320492] $134 114%
Hope Trust Contracted [320488] $186 158%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Lacey St, Cape Girardeau, MO 63701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals