CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Valley Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $86
Cash Discount Price: $265
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Valley Medical Center is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.73x the Medicare baseline. Located in 400 S 43Rd St, Renton, WA.

Cash / Self-Pay

$265

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $265 (225%)

Insurance Median: $86 (73%)

Cash: $265 (225% of Medicare)

Ins. Median: $86 (73% 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.

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	$56 - $203	48%
Humana	$62 - $135	53%
Multiplan Phcs [130109]	$62 - $118	53%
Allied Benefit Systems Llc [110104]	$66 - $92	56%
Chpw Med Advantage [210102]	$86	73%
Medicare (plans)	$86 - $90	73%
Premera Medadvantage [210114]	$86	73%
Regence Medadvantage [210111]	$86	73%
UnitedHealthcare	$86	73%
Wellpoint Medadvantage [210115]	$86	73%
Chpw [130116]	$137	117%
Molina [130117]	$146	124%

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 $265.
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 Valley Medical Center 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.