CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Perham Health

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $85
Cash Discount Price: $114
vs. Medicare Baseline: 0.72x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Perham Health is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $114. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.72x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$114

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $114 (97%)

Insurance Median: $85 (72%)

Cash: $114 (97% of Medicare)

Ins. Median: $85 (72% 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
Medica Mcaid Mn Care	$45 - $113	38%
Blue Cross Blue Shield	$46 - $208	39%
Medica Mn (Msho)	$51 - $127	43%
Ucare Mn Special Needs Basic Care Dual	$51 - $110	43%
Health Partners Mcr Adv	$56 - $105	48%
Humana	$56 - $105	48%
Medica Mcr Adv	$56 - $105	48%
Medicare (plans)	$56 - $116	48%
Ucare Mn Senior Health Options	$56 - $105	48%
Ucare Mn Medical Assistance	$57 - $111	48%
Ucare Mn Minnesota Care	$57 - $111	48%
Ucare Mn Senior Care Plus	$57 - $111	48%
Ucare Mn Special Needs Basic Care	$57 - $111	48%
UnitedHealthcare	$58 - $240	49%
Medicaid / KanCare	$59 - $127	50%
Health Partners Minnesota Care	$62 - $154	53%
Medica Mn Senior Hp/Outside Mn	$63 - $84	54%
Ucare Individual And Family Plan-All Other Plans	$68 - $128	58%
Medica Commercial-All Other Plans	$90 - $225	77%
Health Partners-All Plans	$101 - $253	86%
Preferred One (Ppo)	$105 - $262	89%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$120 - $231	102%
Sanford Health Plan-All Plans	$140 - $262	119%

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 $114.
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 Perham 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.