CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: UPMC Wellsboro

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $88
Cash Discount Price: $134
vs. Medicare Baseline: 0.75x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at UPMC Wellsboro is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.75x the Medicare baseline. Located in 32-36 Central Avenue, Wellsboro, PA.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $134 (114%)

Insurance Median: $88 (75%)

Cash: $134 (114% of Medicare)

Ins. Median: $88 (75% 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
Aetna	$15 - $470	13%
Blue Cross Blue Shield	$17 - $276	14%
Highmark Wholecare (Prev Gateway)	$17 - $109	14%
Upmc Health Plan	$17 - $238	14%
Cigna	$18 - $114	15%
Pa Health & Wellness	$18 - $118	15%
UnitedHealthcare	$18 - $463	15%
Wirerope Works	$47 - $303	40%
Geisinger	$57 - $365	48%
Amerihealth Caritas	$60	51%
Multiplan	$66 - $518	56%
America'S Choice	$76 - $490	65%
Intergroup	$76 - $490	65%
Health Partners Plans (Jefferson Health Plan)	$82	70%
Upmc Work Partners	$127	108%

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 $134.
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 UPMC Wellsboro 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.