New patient office visit (30-44 min)
Facility: Ann & Robert H Lurie Childrens Hospital of Chicago
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $440
- Cash Discount Price: $385
- vs. Medicare Baseline: 3.74x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 374% of the Medicare baseline (a markup of 274%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Psychealth Ltd | $42 | 36% |
| Medicare (plans) | $94 - $2,656 | 80% |
| Mercycare Health | $204 | 174% |
| Cigna | $231 - $390 | 196% |
| La Rabida Childrens Hospital | $275 | 234% |
| Beacon Health Options | $275 | 234% |
| Aetna | $275 - $431 | 234% |
| Blue Cross Blue Shield | $308 - $440 | 262% |
| Independent Physicians at Mercy | $330 | 281% |
| Centegra | $330 | 281% |
| Advanced Physicians Association IPA | $385 | 327% |
| Northwest Community Healthcare | $385 | 327% |
| Methodist First Choice | $385 | 327% |
| Health Plus | $385 | 327% |
| West Suburban Health Providers | $385 | 327% |
| St. Francis | $385 | 327% |
| Presence Health Partners | $385 | 327% |
| Imagine Health | $385 | 327% |
| Ui Health | $385 | 327% |
| Swedish Covenant Physician Partners | $412 | 350% |
| Shriners Hospital | $412 | 350% |
| Magellan | $440 - $900 | 374% |
| American Psych Systems | $440 | 374% |
| Macneal Health | $440 | 374% |
| Health Alliance | $440 | 374% |
| Healthlink Inc. | $454 | 386% |
| Principal Healthcare | $468 | 398% |
| Cofinity | $468 | 398% |
| St. Elizabeth | $468 | 398% |
| Humana | $468 | 398% |
| Hfn Inc | $468 - $495 | 398% |
| Healthstar | $484 | 412% |
| Preferred Health Network | $484 | 412% |
| First Health | $484 | 412% |
| Sagamore Health Network | $484 | 412% |
| Swedish American | $495 | 421% |
| Private Health Care System | $495 | 421% |
| Employer's Coalition on Health | $495 | 421% |
| Benchmark Health | $495 | 421% |
| Security Health Plan | $495 | 421% |
| Beech Street | $495 | 421% |
| Wellmark/Healthnetwork | $506 | 430% |
| National Provider Network | $522 | 444% |
| Wea Insurance Group | $522 | 444% |
| Integrated Health Plan | $522 | 444% |
| Multiplan | $522 | 444% |
| Health Smart | $522 | 444% |
| UnitedHealthcare | $599 - $643 | 509% |
| Unicare | $3,678 - $8,500 | 3128% |