CMS Price Transparency Data
New patient office visit (30-44 min)
Facility: Mercy St Francis Hospital
Billing Code: 99203 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99203
- Insurance Median: $158
- Cash Discount Price: $185
- vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercy St Francis Hospital is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.34x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.
Cash / Self-Pay
$185
Average discount available for prompt cash payment at this facility.
Insurance Median
$158
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: $185 (157%)
Insurance Median: $158 (134%)
Cash: $185 (157% of Medicare)
Ins. Median: $158 (134% 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 | $68 - $128 | 58% |
| Centivo Contracted [320505] | $75 | 64% |
| Medicare (plans) | $78 - $106 | 66% |
| Blue Cross Blue Shield | $80 - $130 | 68% |
| Cigna | $84 - $109 | 71% |
| Globalhealth Contracted [320145] | $84 - $93 | 71% |
| Humana | $84 - $268 | 71% |
| Medical Associates Health Contracted [320444] | $84 - $93 | 71% |
| Pace Of The Ozarks Contracted [320518] | $84 - $93 | 71% |
| Provider Partners Health Plans Contracted [320450] | $84 - $93 | 71% |
| Qual Choice Contracted [320325] | $84 - $93 | 71% |
| Tricare | $92 - $101 | 78% |
| Aetna | $93 - $130 | 79% |
| Cherokee Nation Health Serv Contracted [320066] | $93 - $102 | 79% |
| Cross Timbers Hospice [20098] | $93 - $102 | 79% |
| Dept Of Veteran Affairs Contracted [320106] | $93 - $102 | 79% |
| Elara Caring Aspire Hospice [20433] | $93 - $102 | 79% |
| Halo Hcr Inc Hospice Contracted [320432] | $93 - $102 | 79% |
| Halo Hcr Inc Hospice [20432] | $93 - $102 | 79% |
| Indian Health Service Contracted [320198] | $93 - $102 | 79% |
| Kindful Hospice Contracted [320434] | $93 - $102 | 79% |
| Kindful Hospice [20434] | $93 - $102 | 79% |
| Mercy Hospice Okc [20252] | $93 - $102 | 79% |
| Mercy Mgd Behavioral Health Contracted [320259] | $93 - $102 | 79% |
| UnitedHealthcare | $93 - $283 | 79% |
| Point C Contracted [320238] | $100 - $283 | 85% |
| United Medical Resources Contracted [320454] | $101 - $268 | 86% |
| Ambetter / Centene | $104 | 88% |
| Home State Health Plan Contracted [320187] | $104 | 88% |
| Novasys Contracted [320285] | $104 | 88% |
| Healthlink Contracted [320179] | $111 - $283 | 94% |
| Administrative Payor Contracted [320005] | $122 - $134 | 104% |
| Healthscope Contracted [320182] | $124 - $136 | 105% |
| Multiplan Contracted [320270] | $158 | 134% |
| Private Health Care Systems Contracted [320320] | $158 | 134% |
| Preferred Health Plan Contracted [320522] | $176 - $194 | 150% |
| Workers Comp [20426] | $217 - $253 | 185% |
| Auxiant Contracted [320462] | $244 - $283 | 208% |
| Mercy Benefit Admin Contracted [320251] | $244 - $283 | 208% |
| Aither Health Contracted [320449] | $257 - $283 | 219% |
| Benefit Management Contracted [320052] | $257 - $283 | 219% |
| Ebms Contracted [320493] | $257 - $283 | 219% |
| Edison Health Solutions Contracted [320502] | $257 - $283 | 219% |
| Evolutions Health Care Contracted [320124] | $257 - $283 | 219% |
| First Health Contracted [320128] | $257 - $283 | 219% |
| Health Systems Inc Contracted [320174] | $257 - $283 | 219% |
| Imagine 360 Contracted [320494] | $257 - $283 | 219% |
| Insurance System Inc Contracted [320465] | $257 - $283 | 219% |
| Point C [20238] | $257 - $283 | 219% |
| Reflect Health Contracted [320492] | $257 - $283 | 219% |
| Show-Me Health Administrators Contracted [320483] | $257 - $283 | 219% |
| Usa Managed Care Org Contracted [320429] | $257 - $283 | 219% |
| Yuzu Health Contracted [320521] | $257 - $283 | 219% |