CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Pender Memorial Hospital

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$158

about 1.3× the $118 Medicare rate · typically $130–$265

modeled estimate · not a bill or quote

What this hospital charges insurers

$135

Below the fair price — a good deal

about $23 under the fair price · 1.1× Medicare

Medicare pays $118 Fair price $158 This hospital $135 Cash price $133 Hospital's list price $296

How we calculate the fair BaseRate →

How this hospital compares to other NC hospitals

Highest price of the 9 NC hospitals we have prices for — worth calling around.

Cheapest $48 Priciest $135

Black dot = this hospital, among the 9 NC hospitals with a price for this procedure. Full list below.

A fair price for a New patient office visit (30-44 min) is about $158 (about 1.3× the $118 Medicare rate). Pender Memorial Hospital charges insurers about $135, or about $133 in cash — below the fair price — a good deal. Located in Burgaw, NC.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$136 - $296	116%
Blue Cross Blue Shieldmajor	$50 - $292	43%
Aetnamajor	$51 - $345	43%
Cignamajor	$52 - $179	44%
Humanamajor	$48 - $349	41%
Ambetter (Centene)	$70 - $153	60%
AmeriHealth	$53 - $116	45%
CareSource	$74 - $162	63%
WellCare	$53 - $116	45%
+ 7 smaller / regional plans	$50 - $394

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 133), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99203.

Insurance Before you use insurance

Call your insurance company to confirm Pender Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 99203.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Pender Memorial Hospital

Compare: New patient office visit (30-44 min) at other NC hospitals

Insurance negotiated median for the same procedure, sorted lowest first.