CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Intermountain Health Spanish Fork Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $127
Cash Discount Price: $137
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Intermountain Health Spanish Fork Hospital is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $137. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.08x the Medicare baseline. Located in 765 East Market Place Drive, Spanish Fork, UT.

Cash / Self-Pay

$137

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $137 (117%)

Insurance Median: $127 (108%)

Cash: $137 (117% of Medicare)

Ins. Median: $127 (108% 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
Donor Connect	$12 - $49	10%
Selecthealth	$48 - $296	41%
Health Plan Of Nevada	$55 - $108	47%
Intermountain Caregiver Plan	$77 - $282	65%
Aetna	$81 - $155	69%
American Health	$81 - $108	69%
Blue Cross Blue Shield	$81 - $138	69%
Health Partners Of Nevada	$81 - $108	69%
Healthy U	$81 - $108	69%
Humana	$81 - $108	69%
Molina	$81 - $108	69%
UnitedHealthcare	$81 - $155	69%
Emi	$98	83%
Deseret Mutual	$105	89%
Cigna	$115 - $155	98%
Awh Connected	$117 - $118	100%
Emi Health	$126	107%
Byu Risk Management	$127 - $133	108%
Corporation Of The President	$127 - $133	108%
Pehp	$127 - $162	108%
Wcf Insurance	$127 - $133	108%
Byu Athletics	$131	111%
Campbell Scientific	$131	111%
Corvel Corporation	$131	111%
Franklin County	$131	111%
Ifit	$131	111%
Juniper Systems	$131	111%
Lw Miller	$131	111%
Tanner Llc	$131	111%
Utah Tech	$131	111%
Injury Care Of Nevada	$137	117%
Managed Care Admin	$142	121%
Prodegi Corp Benefit	$149	127%
Uofu	$149	127%
Springtide	$151	128%
Global Excel	$155	132%
Medcare International	$155	132%
Motivhealth	$155	132%
Wise Network	$155	132%
Hygeia Corporation	$164	139%

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 $137.
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 Intermountain Health Spanish Fork 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.