CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Caromont Regional Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $144
Cash Discount Price: $685
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Caromont Regional Medical Center is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $685. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.22x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.

Cash / Self-Pay

$685

Average discount available for prompt cash payment at this facility.

Insurance Median

$144

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: $685 (583%)

Insurance Median: $144 (122%)

Cash: $685 (583% of Medicare)

Ins. Median: $144 (122% 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
Blue Cross Blue Shield	$103 - $136	88%
Carolina Complete Health	$103	88%
Partners Behavioral Health	$103	88%
Alliance Behavioral Health	$105	89%
Amerihealth Caritas	$105	89%
Carolina Complete Health Tailored Plans	$105	89%
UnitedHealthcare	$105 - $364	89%
Vaya Behavioral Health	$105	89%
Wellcare	$105	89%
Aetna	$116 - $222	99%
Devoted Health	$117 - $143	100%
Healthteam	$117 - $143	100%
Longevity Health	$117 - $143	100%
Molina	$117 - $192	100%
Humana	$120 - $603	102%
Absolute Total Care	$192	163%
Surgery Plus	$195 - $238	166%
Gaston County Jail	$206	175%
Cigna	$208 - $253	177%
Carolina Caring	$279 - $543	237%
Corporate Benefits Service	$300 - $366	255%
Medcost	$466	396%
Self Pay	$514	437%
Beech Street	$562	478%
Multiplan	$562	478%
First Health Network	$651	554%

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 $685.
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 Caromont Regional 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.