CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Novant Health Forsyth Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $218
Cash Discount Price: $190
vs. Medicare Baseline: 1.85x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Novant Health Forsyth Medical Center is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.85x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$218

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: $190 (162%)

Insurance Median: $218 (185%)

Cash: $190 (162% of Medicare)

Ins. Median: $218 (185% 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
Carolina Complete	$59	50%
Nc Department Of Public Safety	$59	50%
Amerihealth	$60	51%
Blue Cross Blue Shield	$60 - $228	51%
UnitedHealthcare	$60 - $213	51%
Wellcare	$60	51%
Cigna	$123 - $188	105%
Caresource North Carolina	$127	108%
Aetna	$158 - $254	134%
Atlantic Corporation Dba Atlantic Packaging	$179	152%
Plotkin Health	$190	162%
Amps	$206	175%
Humana	$247	210%
Medcost	$269 - $298	229%
Primary Physician Care	$279	237%
Beechstreet	$285	242%
Multiplan	$285	242%
Phcs	$285	242%
Employers Choice Network	$307	261%
Three Rivers Provider Network	$307	261%

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 $190.
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 Novant Health Forsyth Medical Center 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.