CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Cascade Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $301
Cash Discount Price: $294
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Cascade Medical Center is $301. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $294. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.56x the Medicare baseline. Located in 817 Commercial Street, Leavenworth, WA.

Cash / Self-Pay

$294

Average discount available for prompt cash payment at this facility.

Insurance Median

$301

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: $294 (250%)

Insurance Median: $301 (256%)

Cash: $294 (250% of Medicare)

Ins. Median: $301 (256% 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 256% of the Medicare baseline (a markup of 156%). 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
Aetna	$81 - $837	69%
Asuris Northwest Health	$81 - $837	69%
Blue Cross Blue Shield	$81 - $707	69%
Humana	$81 - $538	69%
Medicare (plans)	$81 - $538	69%
Molina Healthcare Of Washington Mcr Adv	$81 - $543	69%
Wellcare Health Plan Inc Mcr Adv	$87 - $581	74%
Tricare	$114	97%
First Choice Health Network	$145	123%
Pacificsource Health Plans	$145	123%
Medicaid / KanCare	$192 - $497	163%
Community Health Plan Of Wa Mcd Rep	$200 - $517	170%
Coordinated Care Of Wa Mcd Rep	$200 - $517	170%
Molina Healthcare Of Washington Mcd Rep	$200 - $517	170%
Ambetter / Centene	$226 - $583	192%
Community Health Plan Of Wa	$234 - $604	199%
Cigna	$301 - $777	256%
Washington Department Of Labor And Industry	$321 - $830	273%

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 $294.
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 Cascade Medical Center 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.