CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cherry County Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $269
Cash Discount Price: $349
vs. Medicare Baseline: 2.29x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cherry County Hospital is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $349. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.29x the Medicare baseline. Located in 510 North Green St, Valentine, NE.

Cash / Self-Pay

$349

Average discount available for prompt cash payment at this facility.

Insurance Median

$269

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: $349 (297%)

Insurance Median: $269 (229%)

Cash: $349 (297% of Medicare)

Ins. Median: $269 (229% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Molina Mcaid - All Other Plans	$79 - $174	67%
Avera Hmo	$84 - $272	71%
Ambetter / Centene	$111	94%
Avera Aca Ppo	$112 - $272	95%
Blue Cross Blue Shield	$113 - $269	96%
Midlands Choice-All Plans	$117 - $269	100%
Avera Aso Ppo	$131 - $272	111%
Midwest Ntwrk Profee Only - All Plans	$134	114%
Oscar Profee Only - All Plans	$134	114%
Avera Non-Aca Ppo - All Other Plans	$140 - $272	119%
UnitedHealthcare	$153 - $270	130%
Molina Mcr Adv	$188 - $271	160%
First Choice-All Plans	$272 - $405	231%
Multiplan-All Plans	$272 - $405	231%
Phcs-All Plans	$272 - $405	231%
Tlc Advantage-All Plans	$272 - $405	231%

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 $349.
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 Cherry County 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.