CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $397
  • Cash Discount Price: $496
  • vs. Medicare Baseline: 3.38x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at University Medical Center of Princeton at Plainsboro is $397. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $496. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 3.38x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$496

Average discount available for prompt cash payment at this facility.

Insurance Median
$397

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: $496 (422%)
Insurance Median: $397 (338%)
Cash: $496 (422% of Medicare)
Ins. Median: $397 (338% 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 338% of the Medicare baseline (a markup of 238%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $46 - $413 39%
Charity Care $46 39%
Medicaid / KanCare $46 - $496 39%
Wellcare $50 43%
Amerihealth $59 50%
Magellan $59 50%
Horizon Nj Health $68 58%
Blue Cross Blue Shield $100 - $373 85%
Preferred Health Care Eliance $129 110%
Claim Watcher $174 148%
Us Family Health Plan $174 148%
Horizon Behavioral Health $186 158%
Beacon Health Options $248 211%
Magnacare $298 - $347 253%
Princeton Theological Seminary $322 274%
Coventry $347 295%
Health Net $347 295%
UnitedHealthcare $372 316%
Beech Street $397 - $422 338%
Intergrated Health Plan $397 338%
Intergroup $397 338%
Penn Global Medicine Embassy Only $397 338%
Allied Trades $422 359%
Consumer Health Network $422 359%
Devon Health Services $422 359%
First Managed Care Option $422 359%
Ie Shaffer $422 359%
Private Healthcare Systems $422 359%
Qualcare $422 359%
Total Care Network $422 359%
Tri-State $422 359%
Centivo $496 422%
Cigna $496 422%
Clover Health Plan $496 422%
Commercial Other $496 422%
Compsych $496 422%
Concern Plus $496 422%
Elap $496 422%
International Pfs $496 422%
Life St. Francis $496 422%
Managed Health Network $496 422%
Nj Carpenters $496 422%
Penn Behavioral Health Corporate Services $496 422%
Personnel Health Program $496 422%
Tricare $496 422%
United Behavioral Health $496 422%
Va Medical Center $496 422%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals