CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mc Donough District Hospital

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$80
about 0.7× the $118 Medicare rate · typically $69–$114
modeled estimate · not a bill or quote
What this hospital charges insurers
$79
About the fair price
about $1 under the fair price · 0.7× Medicare
Medicare pays $118 Fair price $80 This hospital $79 Cash price $172 Hospital's list price $286

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

Highest price of the 9 IL hospitals we have prices for — worth calling around.

Cheapest $60 Priciest $79

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a New patient office visit (30-44 min) is about $80 (about 0.7× the $118 Medicare rate). Mc Donough District Hospital charges insurers about $79, or about $172 in cash — about the fair price. Located in Macomb, IL.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $74 - $257 63%
Blue Cross Blue Shieldmajor $286 243%
Aetnamajor $69 - $286 59%
Humanamajor $79 - $257 67%
HealthLink $257 - $269 219%
Meridian $79 - $106 67%
Molina $79 - $286 67%
+ 9 smaller / regional plans $48 - $286
Government programs also on file: Medicare, Medicaid.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals