CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: OHSU Hospital and Clinics

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $202
  • Cash Discount Price: $215
  • vs. Medicare Baseline: 1.72x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at OHSU Hospital and Clinics is $202. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.72x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.
Cash / Self-Pay
$215

Average discount available for prompt cash payment at this facility.

Insurance Median
$202

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: $215 (183%)
Insurance Median: $202 (172%)
Cash: $215 (183% of Medicare)
Ins. Median: $202 (172% 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
Community Health Plan Of Washington $28 - $155 24%
Kaiser Foundation Hospitals $70 - $485 60%
Moda $72 - $498 61%
Samaritan Health Plan $80 - $444 68%
Blue Cross Blue Shield $87 - $242 74%
Care Oregon $87 - $485 74%
Pacific Source $88 - $629 75%
Tuality Health $94 - $525 80%
Coventry First Health $109 - $606 93%
First Choice $110 - $612 94%
Health Net Health Plan Of Oregon, Inc. $112 - $626 95%
Aetna $113 - $630 96%
Providence Health Plan $123 - $687 105%
Cigna $133 - $739 113%
Molina Exchange $145 - $808 123%
Medicare (plans) $146 124%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3181 Sw Sam Jackson Park Road, Portland, OR 97239
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals