CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cherokee Regional Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $94
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 0.80x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cherokee Regional Medical Center is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.80x the Medicare baseline. Located in 300 Sioux Valley Drive, Cherokee, IA.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $185 (157%)
Insurance Median: $94 (80%)
Cash: $185 (157% of Medicare)
Ins. Median: $94 (80% 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 $38 - $219 32%
UnitedHealthcare $38 - $219 32%
Wellpoint $38 - $219 32%
Iowa Total Care $40 - $219 34%
Molina $40 - $219 34%
Admin Concepts $72 - $219 61%
Aetna $72 - $219 61%
American Republic $72 - $219 61%
Apw $72 - $219 61%
Auxiant $72 - $219 61%
Avera $72 - $219 61%
Bankers Life $72 - $219 61%
Blue Cross Blue Shield $72 - $219 61%
Champus $72 - $219 61%
Cigna $72 - $219 61%
Humana $72 - $219 61%
Liability $72 - $219 61%
Meridian $72 - $219 61%
Meritain $72 - $219 61%
Midlands $72 - $219 61%
Mutual Of Omaha $72 - $219 61%
Occunet $72 - $219 61%
Physicians Mutual $72 - $219 61%
Private Healthcare $72 - $219 61%
Sanford $72 - $219 61%
United American $72 - $219 61%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Sioux Valley Drive, Cherokee, IA 51012
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals