CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Blount Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $114
Cash Discount Price: $64
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Blount Memorial Hospital is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.97x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $64 (54%)

Insurance Median: $114 (97%)

Cash: $64 (54% of Medicare)

Ins. Median: $114 (97% 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
Prisma Health Seniorcare Pace - Midlands [5400]	$17 - $79	14%
Prisma Health Seniorcare Pace-Upstate [5200]	$17 - $79	14%
Promise Health Plan Contracted [2401]	$26 - $203	22%
Orangeburg Senior Helping Center Pace [5401]	$30 - $136	26%
Blue Cross Blue Shield	$41 - $190	35%
Cigna	$41 - $186	35%
UnitedHealthcare	$42 - $130	36%
Bob Jones Univ-Pai [821]	$44 - $203	37%
Medicaid / KanCare	$52 - $98	44%
Preferred Administrators Contracted [2839]	$52 - $237	44%
Medcost [2940]	$55 - $281	47%
Atlantic Packaging Contracted [4833]	$56 - $254	48%
Aps Healthcare System [2981]	$59 - $271	50%
Multiplan/Phcs Contracted [2950]	$66 - $302	56%
Aetna	$67 - $305	57%
Meritain Health Contracted [2200]	$67 - $305	57%
Nippon [2300]	$67 - $305	57%
Vsp Vision Care [2986]	$67 - $305	57%
First Health Contracted [2952]	$69 - $315	59%
Furman Int/Allen University Student [2951]	$69 - $315	59%
Quiktrip-First Health [3067]	$69 - $315	59%
Tricare	$79 - $120	67%
Mvp Health Care [3037]	$82 - $170	70%
Humana	$112 - $125	95%
Medicare (plans)	$112 - $130	95%
Ambetter / Centene	$174 - $196	148%
Consociate Health Contracted [4835]	$247	210%
Fairos/Occunet Contracted [4837]	$258	219%

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 $64.
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 Blount Memorial 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.