CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Essentia Health Holy Trinity Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $98
Cash Discount Price: $117
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Essentia Health Holy Trinity Hospital is $98. 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 0.83x the Medicare baseline. Located in 115 Second Street West, Box 157, Graceville, MN.

Cash / Self-Pay

$117

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $98 (83%)

Cash: $117 (100% of Medicare)

Ins. Median: $98 (83% 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.

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
Healthpartners Care Pmap	$61	52%
Medica Access	$63	54%
Sanford Healthplan	$68 - $71	58%
Blue Cross Blue Shield	$85 - $138	72%
Healthpartners	$96 - $105	82%
Advocare/Security Health	$98	83%
Freedom Blue Ppo	$98	83%
Healthpartners Care Msho / Mcr Adv	$98	83%
Imcare Msho Pcc Prime	$98	83%
Imcare Msho Ref Req	$98	83%
Medica Advantage Solutions	$98	83%
Medica Msho/Dual Solutions	$98	83%
Medica Prime Solution Group	$98	83%
Medicare (plans)	$98	83%
Nd Va Administration	$98	83%
Platinum Blue/Vantage Blue	$98	83%
Primewest Msho	$98	83%
Secure Blue Msho	$98	83%
Ubh Cost Plan	$98	83%
Ubh Msho	$98	83%
Ucare Msho	$98	83%
UnitedHealthcare	$98 - $143	83%
Ucare	$104	88%
Cigna	$105	89%
Healthpartners Pcc Prime	$105	89%
Wea	$114 - $122	97%
America'S Ppo	$122	104%
Medica	$131 - $138	111%
Medica Uplan	$131	111%
Wps	$133	113%
Aetna	$134	114%
Blue Plus Pmap Pcc Prime	$138	117%
Medica Choice	$142	121%

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 $117.
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 Essentia Health Holy Trinity Hospital 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.