CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Gunnison Valley Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $219
Cash Discount Price: $241
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Gunnison Valley Hospital is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.86x the Medicare baseline. Located in 711 N Taylor St, Gunnison, CO.

Cash / Self-Pay

$241

Average discount available for prompt cash payment at this facility.

Insurance Median

$219

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: $241 (205%)

Insurance Median: $219 (186%)

Cash: $241 (205% of Medicare)

Ins. Median: $219 (186% 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
Gunnison County Sheriff Op & Profee Only	$51 - $203	43%
Ebms Hdhp	$60 - $237	51%
Tetwp Op & Profee Only-All Plans	$60 - $237	51%
U Of Co Transplant-All Plans	$60 - $237	51%
Ebms Ppo Plan-All Other Plans	$70 - $276	60%
Gunnison County Employees-All Other Plans	$80 - $316	68%
Scottish Rites-All Plans	$80 - $316	68%
Elap Employers-All Plans	$85 - $336	72%
Blue Cross Blue Shield	$88 - $346	75%
Multiplan-All Plans	$90 - $356	77%
Rocky Mountain Health-All Plans	$95 - $375	81%
UnitedHealthcare	$95 - $375	81%
Cofinity-All Plans	$96 - $379	82%
Medicaid / KanCare	$103 - $248	88%
Medicare (plans)	$113 - $151	96%
Aetna	$116 - $297	99%
Gunnison County Coroner Op Only	$119 - $159	101%
Apostrophe-All Plans	$132 - $278	112%
Cigna	$132 - $303	112%
Occumed Op Only-All Plans	$262	223%

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 $241.
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 Gunnison Valley Hospital 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.