CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cedar City Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $266
  • Cash Discount Price: $222
  • vs. Medicare Baseline: 2.26x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cedar City Hospital is $266. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $222. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.26x the Medicare baseline. Located in 1303 North Main Street, Cedar City, UT.
Cash / Self-Pay
$222

Average discount available for prompt cash payment at this facility.

Insurance Median
$266

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: $222 (189%)
Insurance Median: $266 (226%)
Cash: $222 (189% of Medicare)
Ins. Median: $266 (226% 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 226% of the Medicare baseline (a markup of 126%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $81 - $285 69%
American Health $81 - $108 69%
Blue Cross Blue Shield $81 - $281 69%
Health Choice $81 - $263 69%
Health Partners Of Nevada $81 - $108 69%
Health Plan Of Nevada $81 - $263 69%
Healthy U $81 - $263 69%
Humana $81 - $108 69%
Molina $81 - $281 69%
Selecthealth $81 - $266 69%
Southwest Behavioral Health $81 - $108 69%
UnitedHealthcare $81 - $266 69%
Corporation Of The President $222 189%
Corvel Corporation $222 189%
Injury Care Of Nevada $222 189%
Wcf Insurance $222 189%
Byu Risk Management $252 214%
Awh Connected $266 - $269 226%
Byu Athletic Department $266 226%
Campbell Scientific $266 226%
Deseret Mutual $266 226%
Emi $266 226%
Emi Health $266 226%
Franklin County $266 226%
Global Excel $266 226%
Ifit $266 226%
Juniper Systems $266 226%
Lw Miller $266 226%
Managed Care Admin $266 226%
Medcare International $266 226%
Motivhealth $266 226%
Pehp $266 - $281 226%
Prodegi Corp Benefit $266 226%
Tanner Llc $266 226%
Uofu $266 - $281 226%
Utah Tech $266 226%
Wise Network $266 226%
Cigna $281 239%
Health Utah $281 239%
Hygeia Corporation $281 239%
Springtide $281 239%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 North Main Street, Cedar City, UT 84721
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals