CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Novant Health Presbyterian Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $238
Cash Discount Price: $211
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Novant Health Presbyterian Medical Center is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.02x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$211

Average discount available for prompt cash payment at this facility.

Insurance Median

$238

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: $211 (179%)

Insurance Median: $238 (202%)

Cash: $211 (179% of Medicare)

Ins. Median: $238 (202% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 202% of the Medicare baseline (a markup of 102%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$52 - $74	44%
Nc Department Of Public Safety	$52 - $74	44%
Amerihealth	$53 - $76	45%
Blue Cross Blue Shield	$53 - $306	45%
UnitedHealthcare	$53 - $248	45%
Wellcare	$53 - $76	45%
Caresource North Carolina	$98 - $140	83%
Atlantic Corporation Dba Atlantic Packaging	$137 - $196	117%
Aetna	$149 - $340	127%
Cigna	$153 - $219	130%
Amps	$164 - $234	139%
Plotkin Health	$179 - $255	152%
Medcost	$212 - $319	180%
Humana	$215 - $306	183%
Primary Physician Care	$221 - $314	188%
Multiplan	$224 - $319	191%
Phcs	$224 - $319	191%
Employers Choice Network	$289 - $412	246%
Three Rivers Provider Network	$289 - $412	246%

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 $211.
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 Presbyterian 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.