CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Southeast Iowa Regional Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $145
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Southeast Iowa Regional Medical Center is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.23x the Medicare baseline. Located in 1221 South Gear Avenue, West Burlington, IA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$145

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%)
Insurance Median: $145 (123%)
Ins. Median: $145 (123% 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
Medicaid / KanCare $49 - $71 42%
Aetna $72 - $185 61%
United Behavioral Health Ma $77 65%
United Behavioral Health Rn $77 - $98 65%
Plain Church $82 - $184 70%
American Healthplan Of Iowa - Midlevel $86 73%
United Behavioral Health Phd $87 74%
United Behavioral Health Md $102 - $115 87%
Humana $105 89%
Absolute Solutions $113 - $188 96%
First Agency $113 - $188 96%
Multiplan $113 - $188 96%
American Healthplan Of Iowa - Md $120 102%
Henderson County $120 - $199 102%
Elap $135 - $193 115%
Wellpoint (Amerigroup) $158 134%
Blue Cross Blue Shield $160 136%
UnitedHealthcare $162 138%
Midlands Choice $164 - $255 139%
Immugrun $178 151%
Brighton Amish Church $184 157%
6 Degree $226 192%
Geha $263 224%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1221 South Gear Avenue, West Burlington, IA 52655
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals