CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Astera Health

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $230
Cash Discount Price: $310
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Astera Health is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $310. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.96x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$310

Average discount available for prompt cash payment at this facility.

Insurance Median

$230

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: $310 (264%)

Insurance Median: $230 (196%)

Cash: $310 (264% of Medicare)

Ins. Median: $230 (196% 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
Blue Plus Pmap [40002]	$52 - $5,128	44%
Ucare Pmap [30006]	$59 - $1,691	50%
Health Partners Pmap [10046]	$60 - $311	51%
Medica Pmap [10057]	$60 - $3,448	51%
Primewest Pmap [30003]	$60 - $3,448	51%
Blue Cross Blue Shield	$85 - $5,128	72%
Health Partners [10045]	$85 - $5,128	72%
Medica Nonpmap [10056]	$85 - $48,102	72%
Primewest Non Pmap [30004]	$85 - $5,128	72%
Ucare Non Pmap [30007]	$85 - $5,385	72%
UnitedHealthcare	$97 - $477	83%
Sanford Health Plan [10120]	$165 - $619	140%
Ucare Commercial [10705]	$197 - $459	168%
Multiplan	$212 - $494	180%
Aetna	$238 - $556	202%

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 $310.
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 Astera Health 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.