CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Geisinger Jersey Shore Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $186
Cash Discount Price: $211
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Geisinger Jersey Shore Hospital is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $211. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.58x the Medicare baseline. Located in 1020 Thompson Street, Jersey Shore, PA.

Cash / Self-Pay

$211

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: $211 (179%)

Insurance Median: $186 (158%)

Cash: $211 (179% 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.

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
Blue Cross Blue Shield	$52 - $212	44%
Medicaid / KanCare	$54	46%
Amerihealth	$60	51%
Geisinger Family Plan	$60	51%
Upmc For You	$64	54%
Geisinger Health Plan	$65 - $175	55%
Health Partners	$65	55%
Upmc Chip	$68	58%
UnitedHealthcare	$144	122%
Cigna	$156	133%
Christian Healthcare Ministries	$162 - $178	138%
Aetna	$226 - $273	192%
Medical Development International	$228 - $250	194%
Integrated Health Plan	$244 - $268	208%
Prime Health Services	$244 - $268	208%
Multiplan	$260 - $286	221%

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 $211.
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 Geisinger Jersey Shore 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.