CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Colleton Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $667
Cash Discount Price: $1,199
vs. Medicare Baseline: 5.67x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Colleton Medical Center is $667. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,199. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 5.67x the Medicare baseline. Located in 501 Robertson Boulevard, Walterboro, SC.

Cash / Self-Pay

$1,199

Average discount available for prompt cash payment at this facility.

Insurance Median

$667

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: $1,199 (1020%)

Insurance Median: $667 (567%)

Cash: $1,199 (1020% of Medicare)

Ins. Median: $667 (567% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 567% of the Medicare baseline (a markup of 467%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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 Choice Health Plan	$73 - $76	62%
Blue Cross Blue Shield	$73 - $1,183	62%
Sc State Employees	$136 - $229	116%
Absolute Total Care	$182 - $224	155%
Aetna	$187 - $721	159%
Nhc Advantage	$237	202%
Pruitt Health	$237	202%
Select Health	$535	455%
Employers Health Network	$560	476%
United	$560 - $661	476%
Value Option	$622	529%
Vocational Rehab	$672	572%
Medcost	$702 - $909	597%
Cigna	$804	684%
Humana	$809 - $1,120	688%
Mhnet	$934	794%
Evernorth	$996	847%
Multiplan	$1,058	900%
North American Administrators	$1,058	900%
Prime Health	$1,058	900%
First Health	$1,120	953%
Novanet	$1,120	953%
United Behavioral Health	$1,245	1059%

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 $1,199.
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 Colleton Medical Center 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.