CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $186
  • Cash Discount Price: $186
  • vs. Medicare Baseline: 1.58x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Independence Health System Butler Memorial Hospita is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $186. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.58x the Medicare baseline. Located in One Hospital Way, Butler, PA.
Cash / Self-Pay
$186

Average discount available for prompt cash payment at this facility.

Insurance Median
$186

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: $186 (158%)
Insurance Median: $186 (158%)
Cash: $186 (158% of Medicare)
Ins. Median: $186 (158% 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
Highmark $50 43%
Highmark - Ind.& Managed Care $50 43%
Highmark Aca - Direct Blue $50 43%
Highmark Community Blue $50 43%
Upmc $52 - $278 44%
Ellwood Group $80 - $114 68%
Martin'S Point - Usfhp $93 79%
Devoted Health Plan $106 90%
Aetna $132 - $216 112%
Ccbh - Behavioral Health $132 - $213 112%
Cigna $132 112%
Pnoa $132 - $212 112%
Workers Comp $136 116%
Behavioral $145 123%
Peak Health $186 158%
Private Healthcare Systems $186 - $225 158%
Devon $199 169%
Intergroup $212 180%
Multiplan $238 202%
Geisinger $265 225%
Gateway $278 236%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Way, Butler, PA 16001
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals