CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Madison County Health Care System

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $187
  • Cash Discount Price: $237
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Madison County Health Care System is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.59x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$237

Average discount available for prompt cash payment at this facility.

Insurance Median
$187

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: $237 (202%)
Insurance Median: $187 (159%)
Cash: $237 (202% of Medicare)
Ins. Median: $187 (159% 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
Choicecare-All Plans $67 - $377 57%
Medical Associates Hp - All Plans $67 - $287 57%
Medimore Employee Hp - All Plans $67 - $389 57%
Tricare $67 - $287 57%
UnitedHealthcare $80 - $357 68%
Iowa Total Care Mcaid-All Plans $92 - $195 78%
Molina Mcaid/Chip -All Plans $95 - $200 81%
Amerigroup Mcaid-All Plans $97 - $207 83%
Madison County Sheriff-All Plans $98 - $198 83%
Blue Cross Blue Shield $105 - $214 89%
Oscar - All Plans $114 - $431 97%
Midlands Choice - All Plans $122 - $389 104%
Aetna $127 - $287 108%
Medigold-All Plans $171 - $287 145%
Corvel Wc-All Plans $176 - $357 150%
American Hp Mcr Adv-All Plans $179 - $302 152%
First Choice-All Plans $185 - $377 157%
First Health-All Plans $185 - $377 157%
Integrated Hp-All Plans $185 - $377 157%
Mutual Of Omaha-All Plans $185 - $377 157%
Plaines Health-All Plans $185 - $377 157%
Preferred Hlth Ntwork-All Plans $185 - $377 157%
Principal Healthcare-All Plans $185 - $377 157%
Usa Managed Care-All Plans $185 - $377 157%
Benefit Admin Of America-All Plans $195 - $397 166%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals