CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Sanford Canby Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $202
  • Cash Discount Price: $195
  • vs. Medicare Baseline: 1.72x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Sanford Canby Medical Center is $202. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $195. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.72x the Medicare baseline. Located in 112 St Olaf Avenue South, Canby, MN.
Cash / Self-Pay
$195

Average discount available for prompt cash payment at this facility.

Insurance Median
$202

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: $195 (166%)
Insurance Median: $202 (172%)
Cash: $195 (166% of Medicare)
Ins. Median: $202 (172% 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 $59 - $200 50%
Sanford Health Plan Align $111 94%
Ucare $120 - $214 102%
Aetna $121 - $212 103%
Health Partners $121 - $195 103%
Medicare (plans) $121 103%
UnitedHealthcare $121 - $204 103%
Primewest $123 - $134 105%
Security Health Plan $134 114%
Sanford Health Plan $193 - $227 164%
Medica $214 - $231 182%
Cigna $220 187%
First Choice Health Network $220 187%
Healthez $220 187%
Multiplan $220 187%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 112 St Olaf Avenue South, Canby, MN 56220
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals