CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Warner Hospital and Health Services

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $255
Cash Discount Price: $300
vs. Medicare Baseline: 2.17x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Warner Hospital and Health Services is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $300. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.17x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$300

Average discount available for prompt cash payment at this facility.

Insurance Median

$255

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: $300 (255%)

Insurance Median: $255 (217%)

Cash: $300 (255% of Medicare)

Ins. Median: $255 (217% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 217% of the Medicare baseline (a markup of 117%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$119 - $294	101%
Aetna	$123 - $255	105%
Health Alliance Med Adv	$123	105%
Humana	$123 - $255	105%
Molina Mcr/Mcd Dual	$123	105%
UnitedHealthcare	$123 - $255	105%
Wellcare Mcr Adv-All Plans	$123	105%
Healthlink Hmo	$234	199%
City Of Clinton (Employees Serv)-All Plans	$240	204%
Cigna	$249	212%
Caterpillar-All Plans	$255	217%
Multiplan Phcs-All Plans	$255	217%
Health Alliance-All Other Plans	$264	225%
Healthlink Ppo/Work Comp-All Other Plans	$264	225%
Consociate Care Ppo-All Plans	$270	230%
Hfn Ppo/Epo-All Plans	$270	230%
Three Rivers-All Plans	$285	242%

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 $300.
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 Warner Hospital and Health Services 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.