CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Ira Davenport Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $136
  • Cash Discount Price: $137
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Ira Davenport Memorial Hospital is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $137. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.16x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.
Cash / Self-Pay
$137

Average discount available for prompt cash payment at this facility.

Insurance Median
$136

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: $137 (117%)
Insurance Median: $136 (116%)
Cash: $137 (117% of Medicare)
Ins. Median: $136 (116% 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
Empire $55 - $66 47%
Fidelis Care - Exchange - All Plans $69 - $172 59%
Geisinger - All Plans $73 - $182 62%
Amerihealth Caritas Mcr Adv - All Plans $77 65%
Blue Cross Blue Shield $77 - $948 65%
Humana $77 - $281 65%
Tricare $77 65%
Cigna $78 - $195 66%
Mvp Health Plan - All Plans $78 - $195 66%
Independent Health - All Plans $81 - $203 69%
Upmc - All Plans $86 - $216 73%
Pomco Inc - All Plans $90 - $225 77%
Aetna $94 - $284 80%
UnitedHealthcare $94 - $335 80%
Emblem Health - All Plans $110 - $275 94%
Martins Point - All Plans $125 - $312 106%
Fidelis $137 - $140 117%
Emblem/Ghi $289 - $295 246%
Healthnow - All Plans $411 - $1,029 350%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7571 State Route 54, Bath, NY 14810
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Rural Emergency Hospital