CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: M Health Fairview University of Mn Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $308
Cash Discount Price: $285
vs. Medicare Baseline: 2.62x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at M Health Fairview University of Mn Medical Center is $308. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.62x the Medicare baseline. Located in 2450 Riverside Avenue, Minneapolis, MN.

Cash / Self-Pay

$285

Average discount available for prompt cash payment at this facility.

Insurance Median

$308

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: $285 (242%)

Insurance Median: $308 (262%)

Cash: $285 (242% of Medicare)

Ins. Median: $308 (262% 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 262% of the Medicare baseline (a markup of 162%). 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
Itasca Medical Care	$56 - $75	48%
Primewest	$56 - $75	48%
South Country Health Alliance	$56 - $75	48%
Ucare	$57 - $208	48%
Medica	$60 - $351	51%
Health Partners	$61 - $944	52%
Hennepin Health	$63	54%
Blue Cross Blue Shield	$65 - $427	55%
Sanford Health Plan	$75 - $268	64%
Security Health Plan	$75 - $332	64%
UnitedHealthcare	$75 - $296	64%
Wellcare	$75	64%
Cigna	$242 - $255	206%
Emerging Therapies	$277 - $291	236%
Humana	$281 - $296	239%
Aetna	$294 - $309	250%
Interlink	$325 - $341	276%
America'S Ppo	$329 - $359	280%
First Health	$355 - $373	302%
Multiplan	$368 - $387	313%
Private Healthcare Systems	$368 - $387	313%
Wisconsin Physician Services	$390 - $410	332%

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 $285.
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 M Health Fairview University of Mn Medical Center 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.