CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Holmes County Hospital and Clinics

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $155
Cash Discount Price: $82
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Holmes County Hospital and Clinics is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.32x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $82 (70%)

Insurance Median: $155 (132%)

Cash: $82 (70% of Medicare)

Ins. Median: $155 (132% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Ms-Can-Molina-Lex	$69	59%
Ms-Can-Magnolia-Lex	$70	60%
Ms-Can-Truecare-Lex	$71	60%
Cigna	$119	101%
Tricare	$126	107%
Blue Cross Blue Shield	$128	109%
Humana	$129	110%
Mpcn-Lex	$134	114%
Medadv_Uhc-Lex	$140	119%
Firstchoice-Lex	$144	122%
Molina-Chip-Lex	$148	126%
Magnolia-Chip-Lex	$151	128%
Truecare-Chip-Lex	$151	128%
Ambetter / Centene	$154	131%
Medadv_Primewell-Lex	$154	131%
Medicare (plans)	$154	131%
Primewell-Lex	$154	131%
United-Lex	$154	131%
Va_Ccn-Lex	$154	131%
United-Options-Lex	$155	132%
Medadv_Uhcdsnp-Lex	$159	135%
Wellcare-Lex	$159	135%
Ppoplus	$161	137%
Devoted_Health-Lex	$162	138%
Firsthealth-Lex	$165	140%
Multiplan-Lex	$165	140%
Aetna	$175	149%
Phcs-Lex	$185	157%
Advhealth-Lex	$206	175%
Molina_Exchange-Lex	$206	175%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $82.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Holmes County Hospital and Clinics is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.