CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $104
  • Cash Discount Price: $98
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Essentia Health St Joseph's Medical Center is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $98. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.88x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$98

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $98 (83%)
Insurance Median: $104 (88%)
Cash: $98 (83% of Medicare)
Ins. Median: $104 (88% 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
Medica Access $46 39%
Healthpartners Care Pmap $62 53%
Sanford Health Plan $62 - $65 53%
Blue Cross Blue Shield $65 - $146 55%
Blue Plus Pmap Pcc Prime $65 - $147 55%
Medica $92 - $103 78%
Medica Uplan $92 78%
Ucare $95 81%
Wea $104 - $112 88%
Medica Choice $106 90%
Cigna $107 91%
Healthpartners $107 91%
Healthpartners Pcc Prime $107 91%
UnitedHealthcare $110 94%
America'S Ppo $112 95%
Wps $120 - $122 102%
Aetna $123 105%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals