CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Bluffton Regional Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $105
  • Cash Discount Price: $65
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Bluffton Regional Medical Center is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.89x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$65

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $65 (55%)
Insurance Median: $105 (89%)
Cash: $65 (55% of Medicare)
Ins. Median: $105 (89% 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
Amish Aid $36 - $49 31%
Physicians Health Plan $36 - $50 31%
Self Pay $36 - $113 31%
Aetna $38 - $92 32%
Lutheran Preferred Network $44 - $165 37%
Php Freedom Network $46 - $65 39%
Cigna $47 - $73 40%
Php $47 - $66 40%
Php Management Systems $57 - $80 48%
Lutheran Trma $59 - $93 50%
UnitedHealthcare $69 - $96 59%
Encore Ppo $72 - $101 61%
Sagamore Sebt $76 - $105 65%
Sagamore Health Newtork Inc $79 - $110 67%
Consumer Life $92 - $128 78%
Ahg Dana Employees $96 - $134 82%
Bccp $102 87%
Veterans Eval Services $102 87%
Align Networks $104 - $144 88%
Prime Health Services $111 - $154 94%
Private Healthcare Systems Inc $111 - $154 94%
Multiplan $118 - $165 100%
Encore Health Network $121 - $185 103%
Advantage 360 $123 - $171 105%
Community Health Alliance $126 - $175 107%
First Health $127 - $177 108%
Allied Benefit Systems $133 - $185 113%
Cardinal Health Alliance $133 - $185 113%
Ppom $133 - $185 113%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals