CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Westfield Memorial Hospital Inc

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $81
  • Cash Discount Price: $396
  • vs. Medicare Baseline: 0.69x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Westfield Memorial Hospital Inc is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $396. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.69x the Medicare baseline. Located in 189 E Main St, Westfield, NY.
Cash / Self-Pay
$396

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $396 (337%)
Insurance Median: $81 (69%)
Cash: $396 (337% of Medicare)
Ins. Median: $81 (69% 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
UnitedHealthcare $21 - $144 18%
Amerihealth $57 - $90 48%
Carelon $57 - $154 48%
Univera $69 - $92 59%
Highmark $71 - $87 60%
Pennsylvania Health And Wellness $72 - $81 61%
Community Care Behavorial Health Healthchoices $75 - $157 64%
Community Care Behavorial Health University Of Pittsburgh Medical Center $75 - $157 64%
Life Pittsburgh $77 65%
Geisinger $79 - $87 67%
Medicare (plans) $81 69%
Jefferson Health Plans $83 71%
American Health Plans $84 71%
Cigna $131 111%
Martin'S Point $247 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 189 E Main St, Westfield, NY 14787
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - RURAL EMERGENCY HOSPITAL (REH)