CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Lafayette Regional Health Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $227
  • Cash Discount Price: $549
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Lafayette Regional Health Center is $227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $549. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.93x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$549

Average discount available for prompt cash payment at this facility.

Insurance Median
$227

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: $549 (467%)
Insurance Median: $227 (193%)
Cash: $549 (467% of Medicare)
Ins. Median: $227 (193% 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
Nhc Advantage $52 - $156 44%
Healthyblue $55 - $165 47%
United $69 - $370 59%
Aetna $72 - $720 61%
Universal Healthcare $72 - $214 61%
Humana $93 - $354 79%
College Park Family Care Center $119 - $354 101%
Oha Network $138 - $411 117%
Cigna $158 - $587 134%
Multiplan $215 - $642 183%
Coventry $220 - $657 187%
Coventry Kc Mo $220 - $657 187%
Cco, Inc. $235 - $699 200%
Corvel Corporation $235 - $699 200%
Focus Healthcare Mgmt, Inc $248 - $741 211%
Blue Cross Blue Shield $276 - $823 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals