CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Guttenberg Municipal Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $296
Cash Discount Price: $315
vs. Medicare Baseline: 2.52x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Guttenberg Municipal Hospital is $296. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $315. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.52x the Medicare baseline. Located in 200 Main Street, Guttenberg, IA.

Cash / Self-Pay

$315

Average discount available for prompt cash payment at this facility.

Insurance Median

$296

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: $315 (268%)

Insurance Median: $296 (252%)

Cash: $315 (268% of Medicare)

Ins. Median: $296 (252% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 252% of the Medicare baseline (a markup of 152%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Molina	$199 - $394	169%
Aetna	$205 - $394	174%
Medical Associates	$205 - $394	174%
UnitedHealthcare	$205 - $394	174%
Wellmark	$205 - $394	174%
Humana	$217 - $394	185%
Iowa Total Care	$236 - $394	201%
Health Partners	$276	235%
Midlands Choice	$276	235%
Quartz	$293 - $315	249%
Health Choices	$339	288%

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 $315.
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 Guttenberg Municipal 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.