CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Ohiohealth Morrow County Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $122
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Ohiohealth Morrow County Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.04x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $112 (95%)
Insurance Median: $122 (104%)
Cash: $112 (95% of Medicare)
Ins. Median: $122 (104% 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
Blue Cross Blue Shield $60 - $153 51%
Medicare (plans) $60 - $75 51%
UnitedHealthcare $60 - $162 51%
Aetna $61 - $170 52%
Humana $61 - $184 52%
Caresource Marketplace - All Other Plans $75 - $92 64%
Medicaid / KanCare $84 - $86 71%
Amerihealth Caritas - All Plans $87 74%
Medical Mutual Of Ohio Marketplace $122 - $149 104%
Ohiohealthy Network - All Other Plans $122 - $149 104%
Ohiohealthy Preferred $122 - $149 104%
Medical Mutual Of Ohio Comm - All Other Plans $131 - $160 111%
Medical Mutual Of Ohio - Admin Serv $138 - $168 117%
Molina Exchange - All Other Plans $139 118%
Phcs - All Plans $149 - $182 127%
Cigna $152 - $186 129%
Multiplan - All Plans $154 - $188 131%
Healthstar Comm - All Plans $156 - $190 133%
Beech Street - All Plans $157 - $192 134%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 West Marion Road, Mount Gilead, OH 43338
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals