CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: St Mary Medical Center

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$81
about 0.7× the $118 Medicare rate · typically $62–$170
modeled estimate · not a bill or quote
What this hospital charges insurers
$120
Above the fair price
about $39 over the fair price · 1.0× Medicare
Medicare pays $118 Fair price $81 This hospital $120 Cash price $240 Hospital's list price $240

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $25 Priciest $120

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a New patient office visit (30-44 min) is about $81 (about 0.7× the $118 Medicare rate). St Mary Medical Center charges insurers about $120, or about $240 in cash — above the fair price. Located in Langhorne, PA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $81. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $81 - $124 69%
Blue Cross Blue Shieldmajor $54 - $178 46%
Aetnamajor $74 - $198 63%
Cignamajor $54 - $204 46%
Humanamajor $54 - $216 46%
Kaiser Permanentemajor $126 107%
Ambetter (Centene) $54 - $174 46%
AmeriHealth $126 107%
Clover Health $120 102%
GEHA $124 105%
Health Net $54 - $138 46%
HealthPartners $54 - $162 46%
Meridian $54 - $120 46%
Molina $54 46%
Oscar Health $181 154%
Paramount $54 46%
Presbyterian $54 - $120 46%
Tufts Health Plan $54 46%
WellMed $120 102%
WellSense $54 46%
+ 338 smaller / regional plans $54 - $240
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 15 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals