CMS Price Transparency Data
New patient office visit (30-44 min)
Facility: Cannon Memorial Hospital
Billing Code: 99203 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99203
- Insurance Median: $120
- Cash Discount Price: $105
- vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cannon Memorial Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.02x the Medicare baseline. Located in 123 W G Acker Drive, Pickens, SC.
Cash / Self-Pay
$105
Average discount available for prompt cash payment at this facility.
Insurance Median
$120
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: $105 (89%)
Insurance Median: $120 (102%)
Cash: $105 (89% of Medicare)
Ins. Median: $120 (102% 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 |
|---|---|---|
| Planned Administrators [886] | $50 - $141 | 43% |
| Medicaid / KanCare | $60 - $275 | 51% |
| Absolute Total Care [58] | $61 - $249 | 52% |
| Humana | $63 - $250 | 54% |
| Select Health Of Sc [637] | $63 - $237 | 54% |
| Employee Benefit Management Services [869] | $70 - $101 | 60% |
| Blue Choice Health Plan [922] | $72 - $158 | 61% |
| Blue Cross Blue Shield | $72 - $261 | 61% |
| Aetna | $75 - $156 | 64% |
| Devoted Health Alt Payer [9401] | $75 - $76 | 64% |
| Devoted Health [94] | $75 - $76 | 64% |
| Medicare (plans) | $75 - $275 | 64% |
| UnitedHealthcare | $75 - $275 | 64% |
| Vaccn - Va Community Care Network [16] | $75 | 64% |
| Veterans Administration [633] | $75 | 64% |
| Cigna | $77 - $275 | 65% |
| Molina Dual Options Alt Payer [1501] | $77 | 65% |
| Molina Dual Options [15] | $77 | 65% |
| Absolute Total Care Mcr Plans Alt Payer [4101] | $78 | 66% |
| Absolute Total Care Mcr Plans [41] | $78 | 66% |
| Champva [604] | $78 | 66% |
| Tricare | $78 | 66% |
| First Choice Vip Careplus Alt Payer [3301] | $79 | 67% |
| First Choice Vip [33] | $79 | 67% |
| Nhc Advantage Alt Payer [6101] | $79 | 67% |
| Nhc Advantage [61] | $79 | 67% |
| Bright Health Alt Payer [1001] | $81 - $87 | 69% |
| Bright Health [11] | $95 | 81% |
| Thomas Cooper & Company [315] | $96 - $141 | 82% |
| Ambetter / Centene | $107 | 91% |
| Preferred Administrators [19] | $108 - $165 | 92% |
| First Choice Next [96] | $109 | 93% |
| Molina Marketplace [97] | $109 | 93% |
| Geha [302] | $110 - $147 | 94% |
| Golden Rule Ins Co [584] | $110 - $147 | 94% |
| Nalc Health Benefit Plan [291] | $111 | 94% |
| Mail Handlers Benefit Plan [327] | $120 - $156 | 102% |
| Rural Carrier Benefit Plan [406] | $120 - $156 | 102% |
| Medcost [206] | $121 - $248 | 103% |
| Workers Compensation [622] | $121 | 103% |
| Edison Health Solutions [95] | $131 | 111% |
| Healthscope [98] | $131 | 111% |
| Phcs [940] | $135 - $185 | 115% |
| Coventry Health [245] | $156 - $198 | 133% |
| Other Hospital Payers [1991] | $188 - $275 | 160% |
| American Continental Ins [778] | $250 - $275 | 213% |
| American Republic Life Ins [722] | $250 - $275 | 213% |
| Business Office [6000] | $250 - $275 | 213% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund [17] | $250 - $275 | 213% |
| First Health [946] | $250 - $275 | 213% |
| Guarantee Trust Life Insurance [236] | $250 - $275 | 213% |
| Home Health Infusion Payer [6001] | $250 - $275 | 213% |
| Manhattan Life Ins Co [932] | $250 - $275 | 213% |
| Miscellaneous Commercial [1] | $250 - $275 | 213% |
| New Era Life Ins Co [437] | $250 - $275 | 213% |
| Non-Contracted [22] | $250 - $275 | 213% |
| Physicians Mutual [773] | $250 - $275 | 213% |
| Reference Based Pricing/Limited Plan [21] | $250 - $275 | 213% |
| State Farm Ins Co [373] | $250 - $275 | 213% |
| Sterling Investors Life [244] | $250 - $275 | 213% |
| Supermed/Med Mutual Of Ohio [539] | $250 - $275 | 213% |
| United American Ins Co [277] | $250 - $275 | 213% |