CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Sanford Medical Center Bismarck

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $195
Cash Discount Price: $222
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Sanford Medical Center Bismarck is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $222. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.66x the Medicare baseline. Located in 300 N 7Th St, Bismarck, ND.

Cash / Self-Pay

$222

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $222 (189%)

Insurance Median: $195 (166%)

Cash: $222 (189% of Medicare)

Ins. Median: $195 (166% 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
Sanford Health Plan	$88 - $118	75%
Sanford Health Plan Align	$101	86%
Ucare	$109 - $201	93%
Aetna	$110 - $235	94%
Blue Cross Blue Shield	$110	94%
Health Partners	$110 - $128	94%
Medicare (plans)	$110	94%
UnitedHealthcare	$110 - $231	94%
Primewest	$112	95%
Security Health Plan	$153	130%
Medica	$189 - $203	161%
Cigna	$250	213%
First Choice Health Network	$250	213%
Healthez	$250	213%
Multiplan	$250	213%

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 $222.
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 Sanford Medical Center Bismarck 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.