CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Charleston Area Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $118
  • Cash Discount Price: $289
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Charleston Area Medical Center is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $289. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.00x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.
Cash / Self-Pay
$289

Average discount available for prompt cash payment at this facility.

Insurance Median
$118

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: $289 (246%)
Insurance Median: $118 (100%)
Cash: $289 (246% of Medicare)
Ins. Median: $118 (100% 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 $58 - $239 49%
The Health Plan Of West Virginia Inc. $58 - $237 49%
Unicare Health Plan Of West Virginia Inc. $58 - $62 49%
Triwest Va $59 - $109 50%
Blue Cross Blue Shield $61 - $222 52%
Choicecare Network $61 - $239 52%
UnitedHealthcare $63 - $239 54%
West Virginia Senior Advantage Inc. $64 - $118 54%
Optimum Choice Inc. $98 - $112 83%
Breast & Cervical Cancer Screening Program $107 91%
Integrated Medical Solutions $119 - $163 101%
Naphcare $122 - $154 104%
City Of Charleston $146 - $183 124%
Tricare $146 - $200 124%
Caresource $152 - $168 129%
Cigna $227 - $331 193%
Three Rivers Providers Network $237 - $324 202%
Healthsmart $239 - $327 203%
Multiplan $239 - $327 203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Morris Street, Charleston, WV 25301
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals