CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Lancaster General Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $101
  • Cash Discount Price: $125
  • vs. Medicare Baseline: 0.86x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Lancaster General Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.86x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$125

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $125 (106%)
Insurance Median: $101 (86%)
Cash: $125 (106% of Medicare)
Ins. Median: $101 (86% 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 $12 - $721 10%
Blue Cross Blue Shield $12 - $905 10%
Hospice And Community Care $12 - $202 10%
Upmc For You $12 - $266 10%
Lg Coresource/Lg Eliance $14 - $304 12%
Old Order Group $14 - $341 12%
Lancashire Hall $15 - $1,065 13%
Nursing Home Op Services $15 - $320 13%
Claim Watcher $18 - $373 15%
Claim Watcher Plus $18 - $373 15%
Affilia Home Health $20 - $1,065 17%
Devoted Health $20 - $426 17%
Medicaid / KanCare $20 - $426 17%
Masonic Homes $21 - $1,065 18%
Highmark $24 - $1,065 20%
Oscar Health Plan $24 - $522 20%
Gateway $25 - $532 21%
Medicare (plans) $25 - $532 21%
Eliance Health Solutions $32 - $682 27%
Highmark Commercial Preferred $33 - $1,065 28%
Cigna $38 - $891 32%
Ehp $41 - $873 35%
Upmc Commercial $41 - $905 35%
Devon $42 - $905 36%
Geisinger Commercial $42 - $905 36%
Intergroup Services $42 - $905 36%
Preferred Healthcare $42 - $905 36%
UnitedHealthcare $42 - $905 36%
Medi-Share Christian Care $48 - $1,012 41%
Commercial Generic $50 - $1,065 43%
Elap Employees $50 - $1,065 43%
Highmark Commercial Non-Preferred $50 - $1,074 43%
Magellan $50 - $1,065 43%
United Behavioral Health $50 - $1,065 43%
Value Options $50 - $1,065 43%
Workers Compensation $50 - $1,065 43%
Gift Of Life Donor Program $13,500 11483%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals