CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Lutheran Hospital of Indiana

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $77
Cash Discount Price: $50
vs. Medicare Baseline: 0.65x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Lutheran Hospital of Indiana is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.65x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.

Cash / Self-Pay

$50

Average discount available for prompt cash payment at this facility.

Insurance Median

$77

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: $50 (43%)

Insurance Median: $77 (65%)

Cash: $50 (43% of Medicare)

Ins. Median: $77 (65% 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
Ky Work Comp	$32 - $52	27%
Physicians Health Plan Of Northern Indiana	$32 - $81	27%
Amish Aid	$38 - $62	32%
Lutheran Preferred Network	$38 - $124	32%
Self Pay	$38 - $74	32%
Cigna	$41 - $75	35%
Php Freedom Network	$42 - $68	36%
Blue Cross Blue Shield	$47 - $76	40%
Aetna	$51 - $98	43%
Lutheran Preferred	$51 - $82	43%
Sagamore	$58 - $111	49%
Encore Ppo	$63 - $101	54%
Lutheran Network	$64 - $103	54%
One Call Care Diagnostics	$68	58%
Multiplan	$93 - $171	79%
Prime Health Services	$96 - $154	82%
Bccp In	$102	87%
Veterans Eval Services	$102	87%
Encore Health Network	$105 - $185	89%
Advantage Health Solutions	$106 - $171	90%
Allied Benefit Systems	$115 - $185	98%
Evolutions	$115 - $185	98%

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 $50.
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 Lutheran Hospital of Indiana 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.