CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cleveland Clinic

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $105
  • Cash Discount Price: $181
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cleveland Clinic is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.89x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$181

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $181 (154%)
Insurance Median: $105 (89%)
Cash: $181 (154% of Medicare)
Ins. Median: $105 (89% 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 $27 - $184 23%
Aetna $28 - $688 24%
Cc Ehp $39 - $147 33%
Zing Health $39 - $85 33%
Ohcp $40 - $268 34%
UnitedHealthcare $40 - $440 34%
Ohio Healthy $41 - $275 35%
Paramount $43 - $74 37%
Aultcare $44 - $296 37%
Buckeye $44 - $75 37%
Caresource $44 - $72 37%
United $45 - $214 38%
Amerihealth $46 39%
Amish Community Aid Plan $46 - $310 39%
Molina $46 - $75 39%
Summacare $49 - $159 42%
Omas $52 - $344 44%
Healthsmart $57 - $378 48%
The Health Plan $57 - $378 48%
Phphi $62 - $413 53%
Upmc $62 - $413 53%
United Bh $65 - $132 55%
Clarity Health $67 - $447 57%
Blue Cross Blue Shield $68 - $215 58%
Gms $72 - $482 61%
Mmo $72 - $482 61%
Quality Care Partners $72 - $482 61%
Consociate Health $77 - $516 65%
Devoted Health $77 65%
Humana $77 - $110 65%
Php $77 65%
Valor $77 65%
Cigna $80 - $550 68%
Communicare $81 69%
Perennial Health $84 71%
Pphp $84 - $85 71%
Medical Benefit Corp $90 77%
Parkview Health Plan $90 77%
Multiplan $93 - $619 79%
Three Rivers $93 - $619 79%
Usa Managed Care $93 - $619 79%
Managed Care Services $97 83%
Community Health Alliance $103 88%
Frontpath $116 99%
Tertiary Care Network $116 99%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals