CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $265
Cash Discount Price: $166
vs. Medicare Baseline: 2.25x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mary Hitchcock Memorial Hospital is $265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $166. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.25x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$166

Average discount available for prompt cash payment at this facility.

Insurance Median

$265

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: $166 (141%)

Insurance Median: $265 (225%)

Cash: $166 (141% of Medicare)

Ins. Median: $265 (225% 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 225% of the Medicare baseline (a markup of 125%). 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
Harvard Pilgrim Health Care of Ne	$59 - $444	50%
Amerihealth Caritas Nh	$61 - $175	52%
Beacon Health Strategies/Carelon	$66 - $170	56%
Wellsense Health Plan	$66 - $175	56%
Granite State Health Plan	$68 - $180	58%
Blue Cross Blue Shield	$79 - $558	67%
Martin's Point Generations Advantage	$79 - $110	67%
Mvp	$79 - $362	67%
UnitedHealthcare	$79 - $415	67%
Martin's Point Health Care	$81 - $187	69%
Aetna	$82 - $380	70%
Cigna	$82 - $424	70%
Ambetter / Centene	$83 - $362	71%
Wellcare Health Plans	$83 - $115	71%
Tufts Health Plan	$251 - $459	213%
Mass General Brigham Health Plan	$293 - $336	249%
Maine Community Health Options	$345 - $398	293%
Coventry	$471	401%
First Health/Hcvm	$471	401%
PHCS	$487	414%
Corvel	$498	424%
Ccmsi	$514	437%

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 $166.
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 Mary Hitchcock Memorial Hospital 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.