CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $138
  • Cash Discount Price: $119
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Alice Peck Day Memorial Hospital is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.17x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.
Cash / Self-Pay
$119

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $119 (101%)
Insurance Median: $138 (117%)
Cash: $119 (101% of Medicare)
Ins. Median: $138 (117% 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
Medicaid / KanCare $61 - $142 52%
Blue Cross Blue Shield $66 - $276 56%
Harvard Pilgrim $83 - $269 71%
UnitedHealthcare $96 - $223 82%
Tufts $98 - $227 83%
Ambetter / Centene $100 85%
Cigna $102 - $254 87%
Commercial Generic $102 - $237 87%
Connecticut General $102 - $237 87%
Klais $103 - $240 88%
Nh Healthy Families $104 88%
Aetna $120 - $279 102%
Mvp $121 - $282 103%
Coventry Health $126 - $294 107%
Coventry Health Wc $126 - $294 107%
Amerihealth Caritas Granite Mcmp $136 116%
Humana $138 - $322 117%
Wellpoint $200 170%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Alice Peck Day Drive, Lebanon, NH 03766
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals