CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Columbia Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $115
  • Cash Discount Price: $139
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Columbia Memorial Hospital is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.98x the Medicare baseline. Located in 71 Prospect Avenue, Hudson, NY.
Cash / Self-Pay
$139

Average discount available for prompt cash payment at this facility.

Insurance Median
$115

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: $139 (118%)
Insurance Median: $115 (98%)
Cash: $139 (118% of Medicare)
Ins. Median: $115 (98% 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 $29 - $100 25%
Cdphp $36 - $173 31%
UnitedHealthcare $38 - $142 32%
Mvp $60 - $146 51%
Medicare (plans) $64 - $118 54%
Blue Cross Blue Shield $73 - $327 62%
Tricare $73 - $118 62%
Aetna $75 - $277 64%
Hamaspik $80 - $148 68%
Fidelis $81 - $130 69%
Cigna $99 - $146 84%
Blue Shield Highmark $115 - $131 98%
Emblem $116 - $189 99%
Emblem Health Ghi $117 - $162 100%
Magnacare $149 - $296 127%
Empire Plan Nyship $164 - $327 139%
Multiplan $174 - $346 148%
Blue Shield $180 - $284 153%
Mvp Commercial $193 - $317 164%
Nascentia Health Options $206 175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Prospect Avenue, Hudson, NY 12534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals