CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Washington County Hospital and Clinics

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $76
Cash Discount Price: $151
vs. Medicare Baseline: 0.65x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Washington County Hospital and Clinics is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.65x the Medicare baseline. Located in 400 East Polk Street, Washington, IA.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$76

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: $151 (128%)

Insurance Median: $76 (65%)

Cash: $151 (128% of Medicare)

Ins. Median: $76 (65% 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
Aetna	$50 - $130	43%
Blue Cross Blue Shield	$54 - $116	46%
Health Alliance Mcr Adv	$54 - $76	46%
Med Assoc Mcr Adv	$54 - $74	46%
Healthpartners Mcr Adv	$55 - $73	47%
Humana	$55 - $76	47%
Ia Total Care Wellcare Mcr Adv	$55 - $77	47%
Molina Mcr Adv - All Other Plans	$55	47%
Wellpoint Mcr Adv Amerigrp - All Other Plans	$55 - $77	47%
Ia Total Care Mcaid	$56 - $268	48%
Medicaid / KanCare	$56 - $268	48%
Wellpoint Mcaid Amerigrp	$56 - $268	48%
Healthpartners - All Other Plans	$114 - $155	97%
Midlands Choice - All Plans	$114 - $120	97%
Health Alliance Comm - All Other Plans	$127 - $188	108%
Med Assoc Hlth Choices Profee Only - All Otherplan	$130	111%
Ambetter / Centene	$132	112%

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 $151.
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 Washington County Hospital and Clinics 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.