CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Sparrow Ionia Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $144
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Sparrow Ionia Hospital is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.22x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

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: $87 (74%)
Insurance Median: $144 (122%)
Cash: $87 (74% of Medicare)
Ins. Median: $144 (122% 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
Aetna $47 - $141 40%
Covenant Advantage $47 - $86 40%
Medicare (plans) $47 - $105 40%
Medigold $47 - $86 40%
Senior Community Care $47 - $86 40%
Humana $49 - $280 42%
Medicaid / KanCare $52 - $72 44%
Priority $115 - $212 98%
Blue Cross Blue Shield $117 - $217 100%
UnitedHealthcare $144 - $265 122%
Cigna $149 - $274 127%
Great West Healthcare $149 - $274 127%
Asr $150 - $277 128%
Blue Care Network $150 - $277 128%
Health Alliance Plan $150 - $277 128%
Cofinity $152 - $280 129%
Mclaren Commercial $168 - $308 143%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3565 S State Road, Ionia, MI 48846
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals