CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Gundersen Palmer Lutheran Hospital and Clinics

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $122
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Gundersen Palmer Lutheran Hospital and Clinics is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.04x the Medicare baseline. Located in 112 Jefferson Street, West Union, IA.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $120 (102%)
Insurance Median: $122 (104%)
Cash: $120 (102% of Medicare)
Ins. Median: $122 (104% 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
Health Partners $106 - $188 90%
UnitedHealthcare $106 - $111 90%
Wellmark $109 - $213 93%
Amerigroup $111 - $213 94%
Humana $111 94%
Iowa Total Care $111 94%
Managed Health Service $111 94%
Ucare $111 - $170 94%
Quartz $116 99%
Alliance $169 - $179 144%
Medical Associates $170 145%
Aspirus Arise Health $177 151%
Multiplan/Healtheos $187 - $198 159%
Coventry Health Care $202 172%
Midland Choice $207 176%
Molina Health $213 181%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 112 Jefferson Street, West Union, IA 52175
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals