CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Harlan County Health System

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $128
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Harlan County Health System is $128. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.09x the Medicare baseline. Located in 717 Brown St, Alma, NE.
Cash / Self-Pay
$132

Average discount available for prompt cash payment at this facility.

Insurance Median
$128

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: $132 (112%)
Insurance Median: $128 (109%)
Cash: $132 (112% of Medicare)
Ins. Median: $128 (109% 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
Humana $20 - $282 17%
Medica Chi Aco - All Other Plans $65 - $128 55%
Medica Chi Health $65 - $67 55%
Medica Choice $65 - $134 55%
Blue Cross Blue Shield $67 - $132 57%
Ohara Llc Wc- All Plans $67 - $245 57%
Tricare $67 - $282 57%
UnitedHealthcare $67 - $258 57%
Medica Ifb Aco $68 - $122 58%
Medica Ifb Open Access $68 - $156 58%
Phcs/Multiplan-All Plans $70 - $201 60%
Aetna $121 - $296 103%
Medica Mcr Adv $129 - $225 110%
Medica Prime Solution $129 - $225 110%
Ambetter / Centene $263 224%
Healthy Blue Mcaid-All Plans $271 231%
Great Plains Mcr Adv-All Plans $296 252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 717 Brown St, Alma, NE 68920
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals