CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Memorial Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $160
  • Cash Discount Price: $190
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Memorial Medical Center is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.36x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$190

Average discount available for prompt cash payment at this facility.

Insurance Median
$160

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: $190 (162%)
Insurance Median: $160 (136%)
Cash: $190 (162% of Medicare)
Ins. Median: $160 (136% 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
Ambetter / Centene $32 - $259 27%
Amerigroup Chip $48 - $274 41%
Amerigroup Star $48 - $274 41%
Amerigroup Star Kids $48 - $274 41%
Amerigroup Star Plus $48 - $274 41%
Comm Health Chip $48 - $274 41%
Comm Health Perinatal-All Other Plans $48 - $274 41%
Molina Chip/Star-All Plans $48 - $274 41%
Scott & White Chip/Star-All Plans $48 - $274 41%
Superior Chip/Star $48 - $274 41%
Texas Childrens Hp - All Plans $48 - $274 41%
Comm Health Mcaid Hmo $50 - $288 43%
Comm Health Star $50 - $288 43%
Aetna $64 - $457 54%
Healthcare Highways-All Plans $65 - $457 55%
Triwest Va Pccc-All Plans $69 - $212 59%
Care Improvement Plus - All Other Plans $70 - $216 60%
Prime Healthcare Services-All Plans $70 - $400 60%
Blue Cross Blue Shield $75 - $159 64%
Capstar Health Network-All Plans $80 - $457 68%
Coventry First Hlth Hmo Ppo-All Other Plans $80 - $457 68%
Coventry First Hlth Mcr Adv $80 - $216 68%
Humana $80 - $457 68%
Corvel Work Comp-All Plans $85 - $485 72%
Galaxy Health Network-All Plans $85 - $485 72%
Independent Med Sys Ppo-All Plans $85 - $485 72%
Multiplan Mcr Adv $85 - $216 72%
Multiplan Phcs Ppo-All Other Plans $85 - $485 72%
Provider Select Ppo-All Plans $85 - $485 72%
Three Rivers Ppo-All Plans $85 - $485 72%
Usa Mso - All Plans $85 - $485 72%
UnitedHealthcare $100 - $457 85%
Amerigroup Mcr Adv-All Other Plans $105 - $216 89%
Superior Allwell Mcr Adv-All Other Plans $105 - $216 89%
Universal American Mcr-All Other Plans $105 - $216 89%
Care Improvement Plus Mcr $106 - $218 90%
Universal American Snp $110 - $227 94%
Cigna $119 - $428 101%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals