CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Kossuth Regional Health Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $177
  • Cash Discount Price: $180
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Kossuth Regional Health Center is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $180. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.51x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.
Cash / Self-Pay
$180

Average discount available for prompt cash payment at this facility.

Insurance Median
$177

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: $180 (153%)
Insurance Median: $177 (151%)
Cash: $180 (153% of Medicare)
Ins. Median: $177 (151% 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
Va Ccn - All Plans $67 - $84 57%
Mercy One - All Plans $71 - $84 60%
Humana $85 - $170 72%
Amerigroup Mcr Adv - All Other Plans $86 73%
UnitedHealthcare $87 - $215 74%
Medical Associates - All Plans $111 - $189 94%
Preferred Health - All Plans $111 - $189 94%
Blue Cross Blue Shield $116 99%
Midlands Choice - All Plans $124 - $155 105%
Health Partners New Bus - All Other Plans $155 - $161 132%
Health Partners Exisiting Bus $177 - $215 151%
Aetna $200 - $215 170%
Multiplan - All Plans $211 - $216 179%
Molina Mcaid/Chip - All Plans $228 - $233 194%
Amerigroup Mcaid $229 - $234 195%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1515 South Phillips Street, Algona, IA 50511
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals