CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: UPMC Chautauqua at Wca

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $139
Cash Discount Price: $130
vs. Medicare Baseline: 1.18x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at UPMC Chautauqua at Wca is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.18x the Medicare baseline. Located in 207 Foote Avenue, Jamestown, NY.

Cash / Self-Pay

$130

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $130 (111%)

Insurance Median: $139 (118%)

Cash: $130 (111% of Medicare)

Ins. Median: $139 (118% 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
United Behavioral Health	$43	37%
Univera	$61 - $72	52%
Upmc Health Plan	$68 - $130	58%
Fidelis	$73	62%
Geisinger	$75	64%
Ccbhn	$82	70%
Health Partners Plans (Jefferson Health Plan)	$82	70%
Aetna	$85 - $140	72%
Magnacare	$106 - $162	90%
UnitedHealthcare	$138 - $140	117%
Humana	$162 - $173	138%
Multiplan	$162	138%
Independent Health	$169 - $199	144%
Ghi/Emblem Health	$173	147%
Statewide Independent Ppo	$190	162%
Affordable First Health	$194	165%

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 $130.
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 UPMC Chautauqua at Wca 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.