CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Adena Regional Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $129
  • Cash Discount Price: $90
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Adena Regional Medical Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.10x the Medicare baseline. Located in 272 Hospital Road, Chillicothe, OH.
Cash / Self-Pay
$90

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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: $90 (77%)
Insurance Median: $129 (110%)
Cash: $90 (77% of Medicare)
Ins. Median: $129 (110% 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
Cigna $65 - $112 55%
Blue Cross Blue Shield $82 - $115 70%
Medical Mutual Of Ohio $82 - $129 70%
Aetna $123 - $129 105%
Buckeye Community Health Plan $123 105%
Humana $123 - $172 105%
Medigold $123 105%
Molina $123 105%
UnitedHealthcare $123 - $130 105%
Care Source $125 106%
Gateway Health $125 106%
Ohio Ppo Connect $126 107%
The Health Plan $126 107%
First Health $142 121%
Ohio Health Choice $144 122%
Healthsmart $154 131%
Integrated Health Plan $172 146%
Multiplan/Private Healthcare Systems $172 146%
Three Rivers Network $172 146%
Molina Marketplace $203 173%
Care Source Just4Me $221 188%
Sidecar Health $338 287%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 272 Hospital Road, Chillicothe, OH 45601
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals