CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Lee County Community Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $66
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Lee County Community Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.56x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $39 (33%)
Insurance Median: $66 (56%)
Cash: $39 (33% of Medicare)
Ins. Median: $66 (56% 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
Aetna $37 - $168 31%
Ambetter / Centene $37 31%
Amerigroup $37 - $168 31%
Managed Medicaire $37 31%
Medicare (plans) $37 31%
Mountain Empire Pace $37 31%
Sentara Health $37 - $43 31%
United Mine Workers Of America $37 31%
UnitedHealthcare $37 - $86 31%
Blue Cross Blue Shield $38 - $168 32%
Humana $38 32%
Molina Healthcare $38 32%
Cigna $39 - $168 33%
Devoted Health Plan $39 33%
Nhc Advantage $39 33%
Seven Corners, Inc. $89 76%
First Health Coventry $168 143%
Medcost $168 143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 127 Health Care Drive, Pennington Gap, VA 24277
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals