CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Ohio State University State Health System

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $152
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Ohio State University State Health System is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.29x the Medicare baseline. Located in 410 West 10Th Avenue, Columbus, OH.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$152

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%)
Insurance Median: $152 (129%)
Ins. Median: $152 (129% 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
Ohio Dept Of Health $79 67%
Osu Health Plan $79 - $128 67%
Ohio Ppo $95 - $114 81%
Mmo $98 - $102 83%
Odrc $104 88%
Healthspan $107 - $122 91%
Humana $117 100%
Cigna $140 119%
Aetna $164 - $213 139%
Ohiohealth $166 - $191 141%
Upper Ohio Valley $168 143%
Lifetrac $173 147%
Frontpath $204 174%
Multiplan $204 174%
Blue Cross Blue Shield $222 - $248 189%
Healthsmart $230 196%
United $304 259%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 410 West 10Th Avenue, Columbus, OH 43210
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals