CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Wabash General Hospital 1

Billing Code: 99203 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$127

about 1.1× the $118 Medicare rate · typically $76–$260

modeled estimate · not a bill or quote

Medicare pays $118 Fair price $127 Cash price $153 Hospital's list price $153

How we calculate the fair BaseRate →

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✓ Cigna HumanaKaiser 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	$48 - $204	41%
Blue Cross Blue Shieldmajor	$45 - $204	38%
Aetnamajor	$101 - $131	86%
Cignamajor	$115	98%
Health Net	$138	117%
HealthLink	$107 - $108	91%
+ 5 smaller / regional plans	$49 - $208

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 153), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99203.

Insurance Before you use insurance

Call your insurance company to confirm Wabash General Hospital 1 is in-network.
Ask your insurer whether prior approval is required for CPT code 99203.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Wabash General Hospital 1

Compare: New patient office visit (30-44 min) at other IL hospitals

Insurance negotiated median for the same procedure, sorted lowest first.