CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Franciscan Health Michigan City

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $210
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Franciscan Health Michigan City is $210. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.79x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$210

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: $68 (58%)
Insurance Median: $210 (179%)
Cash: $68 (58% of Medicare)
Ins. Median: $210 (179% 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
Blue Cross Blue Shield $68 - $194 58%
Medicare (plans) $68 - $141 58%
Aetna $108 - $290 92%
Managed Care [2000] $108 - $348 92%
Unicare [1150] $136 116%
Workers Comp [1172] $136 - $282 116%
Commercial [2001] $158 - $387 134%
United Medical Resources [1158] $158 - $232 134%
United Medical Resources [1301] $158 - $258 134%
UnitedHealthcare $158 - $258 134%
Cigna $159 - $271 135%
Great West Insurance [1055] $159 - $234 135%
Mdwise [1175] $159 135%
Medicaid / KanCare $159 - $191 135%
Managed Health Services [1302] $164 139%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3500 Franciscan Way, Michigan City, IN 46360
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals