CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Jefferson County Health Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $170
  • Cash Discount Price: $167
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Jefferson County Health Center is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.45x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$167

Average discount available for prompt cash payment at this facility.

Insurance Median
$170

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: $167 (142%)
Insurance Median: $170 (145%)
Cash: $167 (142% of Medicare)
Ins. Median: $170 (145% 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
UnitedHealthcare $69 - $649 59%
Tricare $79 - $280 67%
Amerigroup Mcr Adv $81 - $288 69%
Humana $81 - $288 69%
Iowa Total Care Comm - All Other Plans $81 - $288 69%
Iowa Total Care Mcr $81 - $288 69%
Molina Mcr Adv $81 - $288 69%
Iowa Total Care Mcaid $85 - $303 72%
Molina Mcaid/Chip $85 - $303 72%
Medicaid / KanCare $87 - $309 74%
Aetna $99 - $649 84%
Medicare (plans) $99 - $353 84%
Midlands New Product $166 - $591 141%
Coventry Commercial Hmo $173 - $613 147%
Coventry Commercial Ppo - All Other Plans $183 - $649 156%
Midlands Choice-All Other Plans $183 - $649 156%
Molina Marketplace - All Other Plans $203 - $721 173%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals