CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: St Joseph Health System, LLC

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$137

about 1.2× the $118 Medicare rate · typically $79–$187

modeled estimate · not a bill or quote

What this hospital charges insurers

$148

About the fair price

about $11 over the fair price · 1.3× Medicare

Medicare pays $118 Fair price $137 This hospital $148 Cash price $60 Hospital's list price $154

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

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

Cheapest $45 Priciest $148

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

A fair price for a New patient office visit (30-44 min) is about $137 (about 1.2× the $118 Medicare rate). St Joseph Health System, LLC charges insurers about $148, or about $60 in cash — about the fair price. Located in Fort Wayne, IN.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna UnitedHealthcareHumanaKaiser 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
Blue Cross Blue Shieldmajor	$54 - $58	46%
Aetnamajor	$68 - $108	58%
Cignamajor	$48 - $159	41%
Medical Mutual	$148 - $159	126%
+ 11 smaller / regional plans	$36 - $159

Government programs also on file: Military & VA.

Excludes 6 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 60), 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 St Joseph Health System, LLC 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 St Joseph Health System, LLC

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

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