CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Wellspan Chambersburg Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $423
Cash Discount Price: $467
vs. Medicare Baseline: 3.60x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Wellspan Chambersburg Hospital is $423. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $467. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 3.60x the Medicare baseline. Located in 112 North Seventh Street, Chambersburg, PA.

Cash / Self-Pay

$467

Average discount available for prompt cash payment at this facility.

Insurance Median

$423

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: $467 (397%)

Insurance Median: $423 (360%)

Cash: $467 (397% of Medicare)

Ins. Median: $423 (360% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 360% of the Medicare baseline (a markup of 260%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 - $77	43%
Medicare (plans)	$133 - $173	113%
Aetna	$137 - $479	117%
Highmark	$201 - $593	171%
Upmc	$350 - $496	298%
Wellspan_Capital_Blue_Cross	$420	357%
Geisinger	$432	367%
Cigna	$435 - $457	370%
United_Healthcare	$548	466%
First_Health_Network	$555	472%
Performance_Blue	$593	504%

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 $467.
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 Chambersburg 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.