CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Carolina East Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $180
  • Cash Discount Price: $147
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Carolina East Medical Center is $180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.53x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.
Cash / Self-Pay
$147

Average discount available for prompt cash payment at this facility.

Insurance Median
$180

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: $147 (125%)
Insurance Median: $180 (153%)
Cash: $147 (125% of Medicare)
Ins. Median: $180 (153% 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
Pamlico Co Jail-All Plans $64 - $67 54%
Humana $69 59%
Inclusive Health (Nchirp)-All Plans $69 59%
Tricare $69 - $251 59%
UnitedHealthcare $84 - $178 71%
Craven Co. Jail Systems - All Plans $85 - $162 72%
Medcost Ppo Ultra (Employees) $157 - $158 134%
Medcost Ppo Employees And Retirees $158 - $165 134%
Blue Cross Blue Shield $168 - $172 143%
Medcost Ppo City Employees $175 - $183 149%
Medcost Ppo County Employee $182 - $190 155%
Benefit Mgmt, Svcs-All Plans $204 - $213 174%
Medcost Benefit Svc-All Other Plans $212 - $222 180%
Aetna $213 - $222 181%
Acs Consult Svc Inc-All Plans $217 - $227 185%
Medcost Ppo Standard $217 - $227 185%
Cigna $218 - $228 185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Neuse Blvd, New Bern, NC 28560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals