CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Dominion Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $813
  • Cash Discount Price: $1,146
  • vs. Medicare Baseline: 6.92x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Dominion Hospital is $813. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,146. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 6.92x the Medicare baseline. Located in 2960 Sleepy Hollow Road, Falls Church, VA.
Cash / Self-Pay
$1,146

Average discount available for prompt cash payment at this facility.

Insurance Median
$813

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: $1,146 (975%)
Insurance Median: $813 (692%)
Cash: $1,146 (975% of Medicare)
Ins. Median: $813 (692% 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 692% of the Medicare baseline (a markup of 592%). 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 $109 93%
Carefirst $538 - $573 458%
Greenvbrier Sporting Club $687 584%
Value Options $687 584%
Virginia Health Network $813 692%
Corvel $825 702%
Phcs $859 731%
4Most Health Network $1,031 877%
Multiplan $1,031 877%
United Behavioral Health $1,146 975%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2960 Sleepy Hollow Road, Falls Church, VA 22044
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Psychiatric