CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Decatur County Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $186
Cash Discount Price: $213
vs. Medicare Baseline: 1.58x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Decatur County Memorial Hospital is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.58x the Medicare baseline. Located in 720 North Lincoln Street, Greensburg, IN.

Cash / Self-Pay

$213

Average discount available for prompt cash payment at this facility.

Insurance Median

$186

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: $213 (181%)

Insurance Median: $186 (158%)

Cash: $213 (181% of Medicare)

Ins. Median: $186 (158% 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
Blue Cross Blue Shield	$20 - $409	17%
Choice Care Mcr Adv	$20 - $364	17%
Siho Mcr Adv	$20 - $364	17%
UnitedHealthcare	$20 - $360	17%
Caresource Mcr Adv	$21 - $382	18%
Aetna	$23 - $311	20%
Caresource Just4Me-All Other Plans	$34 - $619	29%
Cigna	$52 - $315	44%
Sagamore Health-All Plans	$54 - $327	46%
Encircle-All Plans	$58 - $348	49%
Healthsource Indiana-All Plans	$61 - $368	52%
Choicecare Commercial-All Other Plans	$63 - $380	54%
Thcg/Encore-All Plans	$64 - $384	54%
Siho-All Other Plans	$66 - $397	56%
Medicaid / KanCare	$68 - $409	58%

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 $213.
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 Decatur County Memorial Hospital 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.