CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Phelps Memorial Health Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $206
  • Cash Discount Price: $206
  • vs. Medicare Baseline: 1.75x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Phelps Memorial Health Center is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.75x the Medicare baseline. Located in 1215 Tibbals St, Holdrege, NE.
Cash / Self-Pay
$206

Average discount available for prompt cash payment at this facility.

Insurance Median
$206

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: $206 (175%)
Insurance Median: $206 (175%)
Cash: $206 (175% of Medicare)
Ins. Median: $206 (175% 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
Va Ccn - All Plans $67 - $285 57%
Three Rivers - All Plans $81 - $343 69%
UnitedHealthcare $86 - $286 73%
Providrs Care/Wppa - All Plans $90 - $206 77%
Aetna $101 - $286 86%
Molina Mcaid - All Plans $101 - $229 86%
Provider Network Of American - All Plans $101 - $213 86%
Blue Cross Blue Shield $111 - $286 94%
Partners Hlth Alliance - All Plans $118 - $183 100%
6 Degrees Hlth - All Plans $121 - $183 103%
Medica-All Other Plans $121 - $215 103%
Midwest Ntwrk Alliance - All Plans $128 - $218 109%
Ambetter / Centene $139 - $744 118%
Cpi Benefit Group-All Plans $206 175%
Chi Health Partners - All Plans $218 185%
First Health - All Plans $218 185%
Good Samaritan Mcr Adv - All Plans $286 243%
Medica Mcr Adv $286 243%
Wellcare Mcr Adv - All Plans $286 243%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1215 Tibbals St, Holdrege, NE 68949
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals