CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Island Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $177
Cash Discount Price: $217
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Island Hospital is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $217. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.51x the Medicare baseline. Located in 1211 24Th Street, Anacortes, WA.

Cash / Self-Pay

$217

Average discount available for prompt cash payment at this facility.

Insurance Median

$177

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: $217 (185%)

Insurance Median: $177 (151%)

Cash: $217 (185% of Medicare)

Ins. Median: $177 (151% 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
Molina Mcaid - All Plans	$76 - $250	65%
Aarp Mcr Adv - All Plans	$78 - $250	66%
Multiplan - All Plans	$78 - $212	66%
Samish Indian Health - All Plans	$78 - $250	66%
UnitedHealthcare	$78 - $250	66%
Amerigroup Mcaid - All Plans	$80 - $265	68%
Regence Mcr Adv	$83 - $265	71%
Cigna	$86 - $200	73%
Coordinated Care Mcaid - All Plans	$87 - $250	74%
Chpw Mcaid - All Plans	$89 - $250	76%
Humana	$90 - $250	77%
Kaiser Mcr Adv	$90 - $250	77%
Swinomish Indian Health - All Plans	$90 - $250	77%
First Health - All Plans	$91 - $212	77%
Premera Comm - All Other Plans	$93 - $166	79%
Kaiser Comm - All Other Plans	$95 - $140	81%
First Choice - All Plans	$102 - $212	87%
Regence Comm - All Other Plans	$108 - $188	92%
Aetna	$112 - $262	95%
Premera Mcr Adv	$112 - $262	95%
Tricare	$169 - $250	144%

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 $217.
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 Island 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.