CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mercy Hospital Stoddard

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $133
  • Cash Discount Price: $231
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercy Hospital Stoddard is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $231. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.13x the Medicare baseline. Located in 1200 N One Mile Rd, Dexter, MO.
Cash / Self-Pay
$231

Average discount available for prompt cash payment at this facility.

Insurance Median
$133

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: $231 (196%)
Insurance Median: $133 (113%)
Cash: $231 (196% of Medicare)
Ins. Median: $133 (113% 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 $53 45%
Acentra Health Contracted [320527] $75 64%
Aetna $75 - $267 64%
Blue Cross Blue Shield $75 - $320 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%
Halo Hcr Inc Hospice Contracted [320432] $75 64%
Halo Hcr Inc Hospice [20432] $75 64%
Humana $75 64%
Kindful Hospice Contracted [320434] $75 64%
Kindful Hospice [20434] $75 64%
Medicare (plans) $75 - $78 64%
Mercy Hospice Okc [20252] $75 64%
Pace Of The Ozarks Contracted [320518] $75 64%
Tricare $75 64%
UnitedHealthcare $75 - $182 64%
American Health Advantage Of Mo Mcr Hmo Contracted [320264] $77 65%
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%
Ebms Contracted [320493] $125 106%
Imagine 360 Contracted [320494] $125 106%
Auxiant Contracted [320462] $129 - $152 110%
Healthlink Contracted [320179] $129 - $285 110%
Mercy Benefit Admin Contracted [320251] $129 - $242 110%
Preferred Health Plan Contracted [320522] $133 113%
Reflect Health Contracted [320492] $134 114%
Hope Trust Contracted [320488] $186 158%
Health Alliance Contracted [320164] $231 196%
Aither Health Contracted [320449] $242 206%
Edison Health Solutions Contracted [320502] $242 206%
Mercy Benefit Admin [20251] $242 206%
Yuzu Health Contracted [320521] $242 206%
First Health Contracted [320128] $267 227%
Workers Comp [20426] $267 - $285 227%
Multiplan Contracted [320270] $285 242%
Private Health Care Systems Contracted [320320] $285 242%
Cigna $14,290 12154%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 N One Mile Rd, Dexter, MO 63841
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals