New patient office visit (30-44 min)
Facility: Mercy Hospital of Buffalo
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $107
- Cash Discount Price: $223
- vs. Medicare Baseline: 0.91x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $36 - $139 | 31% |
| Amerigroup [350102] | $36 - $100 | 31% |
| Beacon Essential [350122] | $71 - $94 | 60% |
| Medicaid / KanCare | $71 - $107 | 60% |
| Federal Workers Compensation [500100] | $79 - $115 | 67% |
| Hospice [550001] | $79 - $107 | 67% |
| Medicare (plans) | $79 - $113 | 67% |
| UnitedHealthcare | $81 - $116 | 69% |
| Univera Healthcare Essential [100170] | $88 | 75% |
| Univera Healthcare [100169] | $88 - $121 | 75% |
| Beacon Health Options [100023] | $94 | 80% |
| Fidelis Essential [100163] | $97 - $129 | 83% |
| Tuscarora Nation [550120] | $100 | 85% |
| Independent Health Essential [100166] | $100 | 85% |
| Crime Victims [100176] | $100 | 85% |
| Excellus Rochester McD [350117] | $100 | 85% |
| Vna Option Mltc [350110] | $100 | 85% |
| VA Veterans Affairs [700001] | $107 | 91% |
| Tricare | $107 | 91% |
| Magnacare [100142] | $107 | 91% |
| Aetna | $107 | 91% |
| Humana | $107 | 91% |
| Catholic Health Life Pace [400005] | $107 | 91% |
| Seneca Nation [450119] | $107 | 91% |
| Fallon Health [450115] | $107 | 91% |
| Champ VA [700002] | $107 | 91% |
| Cigna | $107 - $156 | 91% |
| Covid19 Hrsa [45013] | $107 | 91% |
| Meritain [100063] | $107 | 91% |
| UPMC Health Plan [100181] | $108 | 92% |
| Wellcare Fidelis Dual [450451] | $113 | 96% |
| Fidelis Dual Advantage [450120] | $113 | 96% |
| No Fault [114001] | $115 | 98% |
| Iha First Choice [800001] | $116 | 99% |
| Mvp Healthcare [100168] | $116 | 99% |
| Independent Health [100165] | $116 | 99% |
| Ghi [100153] | $118 | 100% |
| Wellcare [450129] | $118 | 100% |
| Fidelis Exchange [100164] | $129 | 110% |
| Molina Essential [100167] | $224 | 191% |