CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Lewisgale Hospital Montgomery

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $382
Cash Discount Price: $509
vs. Medicare Baseline: 3.25x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Lewisgale Hospital Montgomery is $382. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $509. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 3.25x the Medicare baseline. Located in 3700 South Main Street, Blacksburg, VA.

Cash / Self-Pay

$509

Average discount available for prompt cash payment at this facility.

Insurance Median

$382

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: $509 (433%)

Insurance Median: $382 (325%)

Cash: $509 (433% of Medicare)

Ins. Median: $382 (325% 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 325% of the Medicare baseline (a markup of 225%). 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
Aetna	$76 - $270	65%
Lifeworks	$97	83%
Universal Healthcare Group	$112	95%
Virginia Health Network	$178 - $361	151%
United	$197 - $229	168%
Greenvbrier Sporting Club	$305	259%
Corvel	$366	311%
Richfield Nursing Center	$382	325%
Richfield Retirement Community	$382	325%
Multiplan	$392	333%
Community Care Network	$407	346%
Graham-White Manufacturing	$407	346%
Occunet Workers Comp	$407	346%
One Health Plan	$407	346%
Phcs	$433	368%
Patients Choice	$448	381%
4Most	$458	390%
American Postal Workers Union	$458	390%
Star Transportation	$458	390%

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 $509.
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 Lewisgale Hospital Montgomery 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.