CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Arbor Health Morton Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $146
Cash Discount Price: $197
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Arbor Health Morton Hospital is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.24x the Medicare baseline. Located in 521 Adams Street, Morton, WA.

Cash / Self-Pay

$197

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

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: $197 (168%)

Insurance Median: $146 (124%)

Cash: $197 (168% of Medicare)

Ins. Median: $146 (124% 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
First Choice-All Plans	$51 - $296	43%
Amerigroup-All Other Plans	$56 - $145	48%
Comm Health Healthy Options	$56 - $137	48%
Kaiser Mcaid	$56 - $137	48%
Molina Mcaid	$56 - $264	48%
UnitedHealthcare	$56 - $254	48%
Comm Health Basic Sub - All Other Plans	$67 - $270	57%
Comm Health Pebb	$101 - $270	86%
Kaiser Comm-All Other Plans	$103 - $250	88%
Aetna	$127 - $280	108%
Amerigroup Mcr Adv	$146	124%
Comm Health Mcr Adv	$146	124%
Healthnet Mcr Adv - All Plans	$146	124%
Humana	$146	124%
Mcr Railroad Mcr Adv - All Plans	$146	124%
Medicare (plans)	$146	124%
Premera Hmo Mcr Adv	$146	124%
Rural Health Mcare - All Plans	$146	124%
Regence Blue Shield Mcr Adv	$148	126%
Molina Mcr Adv	$154 - $159	131%
Wellcare Mcr Adv - All Plans	$154	131%
Molina Marketplace-All Other Plans	$187 - $191	159%
Regence Blue Shield Ump-All Other Plans	$223	190%
Premera First-All Other Plans	$286	243%
Cigna	$296	252%

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 $197.
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 Arbor Health Morton 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.