CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cheshire Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $243
Cash Discount Price: $149
vs. Medicare Baseline: 2.07x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cheshire Medical Center is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.07x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$243

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: $149 (127%)

Insurance Median: $243 (207%)

Cash: $149 (127% of Medicare)

Ins. Median: $243 (207% 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 207% of the Medicare baseline (a markup of 107%). 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
Amerihealth Caritas Nh	$66 - $106	56%
Wellsense Health Plan	$75 - $115	64%
Aetna	$82 - $370	70%
Ambetter / Centene	$85 - $115	72%
Blue Cross Blue Shield	$85 - $430	72%
Cigna	$85 - $276	72%
Martin'S Point Generations Advantage	$85 - $115	72%
Martin'S Point Health Care	$85 - $115	72%
Mvp	$85 - $276	72%
UnitedHealthcare	$85 - $411	72%
Wellcare Health Plans	$85 - $115	72%
Granite State Health Plan	$90 - $106	77%
Harvard Pilgrim Health Care Of Ne	$115 - $246	98%
Tufts Health Plan	$212 - $345	180%
Maine Community Health Options	$243	207%
Mass General Brigham Health Plan	$282 - $541	240%
First Health/Hcvm	$460	391%
Phcs	$487	414%

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 $149.
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 Cheshire Medical Center 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.