CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cass County Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $74
Cash Discount Price: $123
vs. Medicare Baseline: 0.63x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cass County Memorial Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.63x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $123 (105%)

Insurance Median: $74 (63%)

Cash: $123 (105% of Medicare)

Ins. Median: $74 (63% 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
Midlands Choice Medica Mcr	$14 - $35	12%
Triwest - All Plans	$28 - $71	24%
Aetna	$29 - $166	25%
Amerigroup Mcr Adv - All Other Plans	$29 - $74	25%
Tricare	$29 - $74	25%
UnitedHealthcare	$29 - $159	25%
Va Ccn - All Plans	$29 - $74	25%
Wellmark Mcr Adv	$29 - $74	25%
American Hlth Mcr Adv - All Plans	$30 - $76	26%
Iowa Total Care Mcaid	$30 - $174	26%
Iowa Total Care Mcr	$30 - $75	26%
Medicaid / KanCare	$30 - $224	26%
Molina Mcaid - All Plans	$30 - $228	26%
Iowa Total Care Comm - All Other Plans	$32 - $81	27%
Midlands Choice New Bus	$45 - $144	38%
Midlands Choice Pho (Ppo) - All Other Plans	$62 - $158	53%
Multiplan - All Plans	$66 - $213	56%
Medica Mcr Adv	$74	63%
Wellmark Hmo	$116	99%
Wellmark Ppo - All Other Plans	$116	99%
Medica Comm - All Other Plans	$154 - $197	131%

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 $123.
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 Cass County Memorial Hospital 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.