CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Incline Village Community Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $143
Cash Discount Price: $188
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Incline Village Community Hospital is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $188. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.22x the Medicare baseline. Located in 880 Alder Street, Incline Village, NV.

Cash / Self-Pay

$188

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $188 (160%)

Insurance Median: $143 (122%)

Cash: $188 (160% of Medicare)

Ins. Median: $143 (122% 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.

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
Medicare (plans)	$59	50%
Blue Cross Blue Shield	$63 - $202	54%
Ca Hlth And Wellness - All Plans	$72 - $154	61%
Healthnet - All Plans	$95 - $143	81%
UnitedHealthcare	$106 - $136	90%
Aetna	$133 - $198	113%
Prominence Healthfirst - All Plans	$133 - $198	113%
Admar Multiplan - All Plans	$136 - $202	116%
First Health - All Plans	$136 - $202	116%
Great West/One Health - All Plans	$136 - $202	116%
Hometown Hp - All Plans	$136 - $202	116%
Humana	$136 - $202	116%
Interplan - All Plans	$136 - $202	116%
Multiplan - All Plans	$136 - $202	116%
Phcs - All Plans	$136 - $202	116%
Cigna	$139 - $207	118%
Beech Street/Capp Care - All Plans	$143 - $214	122%
Uhn - All Plans	$143 - $214	122%
Sierra Health - All Plans	$146 - $218	124%

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 $188.
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 Incline Village Community 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.