CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Sanford Worthington Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $174
  • Cash Discount Price: $360
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Sanford Worthington Medical Center is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $360. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.48x the Medicare baseline. Located in 1018 Sixth Avenue Po Box 997, Worthington, MN.
Cash / Self-Pay
$360

Average discount available for prompt cash payment at this facility.

Insurance Median
$174

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: $360 (306%)
Insurance Median: $174 (148%)
Cash: $360 (306% of Medicare)
Ins. Median: $174 (148% 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
Sanford Health Plan $75 - $322 64%
Blue Cross Blue Shield $87 - $318 74%
Sanford Health Plan Align $101 86%
Security Health Plan $106 - $389 90%
Ucare $109 - $552 93%
Aetna $110 - $580 94%
Health Partners $110 - $502 94%
Medicare (plans) $110 94%
UnitedHealthcare $110 - $590 94%
Primewest $112 95%
Medica $172 - $675 146%
First Choice Health Network $174 - $636 148%
Healthez $174 - $636 148%
Multiplan $174 - $636 148%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1018 Sixth Avenue Po Box 997, Worthington, MN 56187
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals