CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Essentia Health Sandstone

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $74
  • Cash Discount Price: $117
  • vs. Medicare Baseline: 0.63x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Essentia Health Sandstone is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $117. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.63x the Medicare baseline. Located in 705 Lundorff Drive South, Sandstone, MN.
Cash / Self-Pay
$117

Average discount available for prompt cash payment at this facility.

Insurance Median
$74

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: $117 (100%)
Insurance Median: $74 (63%)
Cash: $117 (100% of Medicare)
Ins. Median: $74 (63% 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
Blue Cross Blue Shield $61 - $127 52%
Blue Plus Pmap Pcc Prime $61 52%
Medica Access $63 54%
Healthpartners Care Pmap $64 54%
Sanford Healthplan $68 - $71 58%
Advocare/Security Health $74 63%
Freedom Blue Ppo $74 63%
Healthpartners Care Msho / Mcr Adv $74 63%
Imcare Msho Pcc Prime $74 63%
Imcare Msho Ref Req $74 63%
Medica Advantage Solutions $74 63%
Medica Msho/Dual Solutions $74 63%
Medica Prime Solution Group $74 63%
Medicare (plans) $74 63%
Nd Va Administration $74 63%
Platinum Blue/Vantage Blue $74 63%
Primewest Msho $74 63%
Secure Blue Msho $74 63%
Ubh Cost Plan $74 63%
Ubh Msho $74 63%
Ucare Msho $74 63%
UnitedHealthcare $74 - $144 63%
Ucare $104 88%
Healthpartners $107 - $123 91%
Medica $113 - $126 96%
Medica Uplan $113 96%
Wea $114 - $122 97%
America'S Ppo $122 104%
Cigna $123 105%
Healthpartners Pcc Prime $123 105%
Medica Choice $129 110%
Wps $133 113%
Aetna $134 114%
Security Health $158 134%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 705 Lundorff Drive South, Sandstone, MN 55072
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals