CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Franciscan Health Munster

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $239
Cash Discount Price: $90
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Franciscan Health Munster is $239. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.03x the Medicare baseline. Located in 701 Superior Ave, Munster, IN.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$239

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: $90 (77%)

Insurance Median: $239 (203%)

Cash: $90 (77% of Medicare)

Ins. Median: $239 (203% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Workers Comp [1172]	$136 - $282	116%
Medicare (plans)	$141	120%
Cigna	$146 - $339	124%
Commercial [2001]	$166 - $339	141%
Managed Care [2000]	$166 - $373	141%
United Medical Resources [1158]	$166 - $373	141%
United Medical Resources [1301]	$166 - $373	141%
UnitedHealthcare	$166 - $373	141%
Blue Cross Blue Shield	$172 - $373	146%
Aetna	$224 - $323	191%
Great West Insurance [1055]	$235 - $339	200%

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 $90.
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 Franciscan Health Munster 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.