CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $216
  • Cash Discount Price: $247
  • vs. Medicare Baseline: 1.84x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.84x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.
Cash / Self-Pay
$247

Average discount available for prompt cash payment at this facility.

Insurance Median
$216

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: $247 (210%)
Insurance Median: $216 (184%)
Cash: $247 (210% of Medicare)
Ins. Median: $216 (184% 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.

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
The Alliance $54 - $211 46%
Security Health Plan (Shp) $55 - $240 47%
Amish/Mennonite $58 - $228 49%
Quartz $60 - $237 51%
Wps Health Insurance $71 - $279 60%
Cigna $72 - $307 61%
Health Payment Systems $74 - $289 63%
UnitedHealthcare $79 - $280 67%
Humana $84 - $369 71%
Group Health Cooperative Of Eau Claire $87 - $394 74%
Network Health Plan $89 - $347 76%
First Health $90 - $353 77%
Molina Healthcare Of Wi $90 - $353 77%
Trilogy $95 - $374 81%
Healtheos By Multiplan Inc. $99 - $394 84%
Health Partners $101 - $394 86%
Coventry $102 - $398 87%
Blue Cross Blue Shield $530 - $796 451%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 707 S University Ave, Beaver Dam, WI 53916
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals