CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Wellspan York Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $147
Cash Discount Price: $202
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Wellspan York Hospital is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.25x the Medicare baseline. Located in 1001 South George Street, York, PA.

Cash / Self-Pay

$202

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $202 (172%)

Insurance Median: $147 (125%)

Cash: $202 (172% of Medicare)

Ins. Median: $147 (125% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medicaid / KanCare	$50 - $225	43%
Johns_Hopkins_Healthcare_Plan	$77 - $712	65%
Medicare (plans)	$77 - $136	65%
Aetna	$80 - $683	68%
Blue_Cross	$88 - $610	75%
Highmark	$116 - $778	99%
First_Health_Network	$134 - $683	114%
Cigna	$138 - $670	117%
Phc	$140 - $675	119%
Wellspan_Capital_Blue_Cross	$143 - $690	122%
Geisinger	$147 - $712	125%
Upmc	$147 - $712	125%
United_Healthcare	$238 - $706	202%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $202.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Wellspan York Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.