CMS Price Transparency Data
New patient office visit (30-44 min)
Facility: Mercy Hospital Logan County
Billing Code: 99203 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99203
- Insurance Median: $173
- Cash Discount Price: $193
- vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercy Hospital Logan County is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.47x the Medicare baseline. Located in 200 S Academy Rd, Guthrie, OK.
Cash / Self-Pay
$193
Average discount available for prompt cash payment at this facility.
Insurance Median
$173
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: $193 (164%)
Insurance Median: $173 (147%)
Cash: $193 (164% of Medicare)
Ins. Median: $173 (147% 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 |
|---|---|---|
| Aetna | $68 - $180 | 58% |
| Blue Cross Blue Shield | $68 - $162 | 58% |
| Dept Of Veteran Affairs Contracted [320106] | $68 - $78 | 58% |
| Humana | $68 - $98 | 58% |
| Independent Health [20197] | $68 - $78 | 58% |
| Medical Associates Health [20444] | $68 - $78 | 58% |
| Medicare (plans) | $68 - $153 | 58% |
| Provider Partners Health Plans Contracted [320450] | $68 - $78 | 58% |
| Qual Choice Contracted [320325] | $68 - $78 | 58% |
| Tribute Health Plan Mcr Contracted [320338] | $68 - $78 | 58% |
| Globalhealth Contracted [320145] | $69 - $80 | 59% |
| Cigna | $70 - $260 | 60% |
| Tricare | $71 - $76 | 60% |
| Cherokee Nation Health Serv Contracted [320066] | $73 - $78 | 62% |
| Cross Timbers Hospice [20098] | $73 - $78 | 62% |
| Elara Caring Aspire Hospice Contracted [320433] | $73 - $78 | 62% |
| Elara Caring Aspire Hospice [20433] | $73 - $78 | 62% |
| Halo Hcr Inc Hospice Contracted [320432] | $73 - $78 | 62% |
| Halo Hcr Inc Hospice [20432] | $73 - $78 | 62% |
| Indian Health Service Contracted [320198] | $73 - $78 | 62% |
| Kindful Hospice Contracted [320434] | $73 - $78 | 62% |
| Kindful Hospice [20434] | $73 - $78 | 62% |
| Mercy Hospice Okc [20252] | $73 - $78 | 62% |
| UnitedHealthcare | $73 - $214 | 62% |
| Health Choice Contracted [320166] | $79 | 67% |
| Ambetter / Centene | $86 - $92 | 73% |
| Home State Health Plan Contracted [320187] | $86 - $92 | 73% |
| Medicaid / KanCare | $86 - $98 | 73% |
| Novasys Contracted [320285] | $86 - $92 | 73% |
| Webtpa Contracted [320417] | $121 - $129 | 103% |
| Medica Contracted [320239] | $144 - $153 | 122% |
| Aither Health Contracted [320449] | $173 - $260 | 147% |
| Auxiant Contracted [320462] | $173 - $260 | 147% |
| Federal Medical Center Contracted [320127] | $173 - $184 | 147% |
| Healthlink Contracted [320179] | $173 - $260 | 147% |
| Healthscope Contracted [320182] | $173 - $184 | 147% |
| Mercy Benefit Admin Contracted [320251] | $173 - $260 | 147% |
| Point C Contracted [320238] | $173 - $184 | 147% |
| Preferred Health Plan Contracted [320522] | $173 - $184 | 147% |
| Show-Me Health Administrators Contracted [320483] | $173 - $184 | 147% |
| United Medical Resources Contracted [320454] | $173 - $214 | 147% |
| Community Care Contracted [320080] | $202 - $214 | 172% |
| Osma Health Contracted [320292] | $202 - $214 | 172% |
| United Behavioral Health Contracted [320390] | $202 - $214 | 172% |
| Benefit Management Contracted [320052] | $216 - $275 | 184% |
| Globalhealth Contracted [320144] | $216 - $230 | 184% |
| Healthcare Highways Plus Contracted [320175] | $216 - $230 | 184% |
| Private Health Care Systems Contracted [320320] | $216 - $245 | 184% |
| First Health Contracted [320128] | $225 - $239 | 191% |
| Multiplan Contracted [320270] | $230 - $275 | 196% |
| Ebms Contracted [320493] | $245 - $260 | 208% |
| Imagine 360 Contracted [320494] | $245 - $260 | 208% |
| Preferred Community Choice Contracted [320311] | $245 - $260 | 208% |
| Reflect Health Contracted [320492] | $245 - $260 | 208% |
| Yuzu Health Contracted [320521] | $245 - $260 | 208% |