CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Reading Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $98
  • Cash Discount Price: $173
  • vs. Medicare Baseline: 0.83x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Reading Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.83x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.
Cash / Self-Pay
$173

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $173 (147%)
Insurance Median: $98 (83%)
Cash: $173 (147% of Medicare)
Ins. Median: $98 (83% 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
Humana $59 - $72 50%
Magellan $61 52%
UnitedHealthcare $62 - $198 53%
Blue Cross Blue Shield $69 - $157 59%
Amerihealth Caritas $70 60%
Highmark $70 - $87 60%
Upmc $70 - $132 60%
Aetna $72 - $208 61%
Devoted Health $72 61%
Geisinger $72 - $329 61%
Health America $72 61%
Health Partners $73 - $139 62%
Pa Health & Wellness $73 - $111 62%
Gateway $74 - $139 63%
Pma $98 83%
Quest Behavioral Health $105 89%
Lehigh Valley Health Network $110 - $156 94%
United Behavioral Health $121 103%
Cigna $135 - $191 115%
First Health $148 - $208 126%
Berkshire $184 157%
Blue Ridge $233 198%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 420 S 5Th Avenue, West Reading, PA 19611
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals