CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Fairfield Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $121
  • Cash Discount Price: $78
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Fairfield Medical Center is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.03x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.
Cash / Self-Pay
$78

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

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: $78 (66%)
Insurance Median: $121 (103%)
Cash: $78 (66% of Medicare)
Ins. Median: $121 (103% 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
Oscar $61 - $17,500 52%
Medical Mutual $78 - $33,500 66%
Medicaid / KanCare $84 71%
Molina $84 - $168 71%
UnitedHealthcare $84 - $142 71%
Caresource $85 72%
Blue Cross Blue Shield $87 - $26,250 74%
Humana $87 - $50,000 74%
Amerihealth Caritas Ohio $88 75%
Buckeye Community Health $88 75%
Aetna $114 97%
The Health Plan $120 102%
Allied Benefit Systems $121 103%
Meritain Health $121 103%
Quality Care Partners/Ohio Ppo Connect $125 106%
The Ohio State Health Plan $134 114%
Cigna $143 122%
Ohio Healthy $164 139%
Multiplan $165 140%
Miscellaneous Plans $174 148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 North Ewing Street, Lancaster, OH 43130
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals