CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Banner Churchill Community Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $474
  • Cash Discount Price: $1,189
  • vs. Medicare Baseline: 4.03x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Banner Churchill Community Hospital is $474. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,189. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 4.03x the Medicare baseline. Located in 801 East Williams Avenue, Fallon, NV.
Cash / Self-Pay
$1,189

Average discount available for prompt cash payment at this facility.

Insurance Median
$474

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: $1,189 (1011%)
Insurance Median: $474 (403%)
Cash: $1,189 (1011% of Medicare)
Ins. Median: $474 (403% 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 403% of the Medicare baseline (a markup of 303%). 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 $94 - $2,181 80%
Banner Health $115 - $742 98%
Hometown Health $115 - $2,204 98%
Silversummit Healthplan $115 - $2,088 98%
Triwest Healthcare Alliance Corp - Va Ccn $115 - $951 98%
UnitedHealthcare $115 - $2,088 98%
Humana $122 - $787 104%
Nevada Preferred Healthcare Providers $324 - $2,088 276%
Blue Cross Blue Shield $331 - $2,134 282%
Multiplan $338 - $2,181 287%
Cigna $340 - $2,190 289%
Coventry $346 - $2,227 294%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 801 East Williams Avenue, Fallon, NV 89406
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals