CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Dupont Hospital LLC

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $81
Cash Discount Price: $55
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Dupont Hospital LLC is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.69x the Medicare baseline. Located in 2520 E Dupont Rd, Fort Wayne, IN.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$81

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: $55 (47%)

Insurance Median: $81 (69%)

Cash: $55 (47% of Medicare)

Ins. Median: $81 (69% 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
Physicians Health Plan	$36 - $62	31%
Amish Aid	$40 - $43	34%
Self Pay	$40 - $72	34%
Lutheran Preferred	$44 - $95	37%
Cigna	$48 - $58	41%
Php Freedom Network	$49 - $53	42%
Aetna	$55 - $71	47%
Encore Ppo	$74 - $80	63%
Lutheran Network	$74 - $80	63%
Medical Mutual Of Oh	$78 - $84	66%
Sagamore	$80 - $89	68%
Bccp	$102	87%
Veterans Eval Services	$102	87%
Prime Health Services	$111 - $119	94%
Frontpath	$118 - $127	100%
Encore Health Network	$121 - $143	103%
Advantage Health Solutions	$123 - $132	105%
Multiplan	$127 - $143	108%
Allied Benefit Systems	$133 - $143	113%

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 $55.
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 Dupont Hospital LLC 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.