CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Beloit Health System

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $171
Cash Discount Price: $77
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Beloit Health System is $171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.45x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$171

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: $77 (65%)

Insurance Median: $171 (145%)

Cash: $77 (65% of Medicare)

Ins. Median: $171 (145% 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
Aetna	$70 - $326	60%
Blue Cross Blue Shield	$70 - $235	60%
Dean Health	$70 - $203	60%
Independent Care Health Plan	$70	60%
Quartz	$70 - $235	60%
UnitedHealthcare	$70 - $77	60%
Cook Children'S Health Plan (Cchp)	$77	65%
Wea Trust	$88 - $199	75%
Naphcare	$105 - $217	89%
Multiplan	$128 - $290	109%
Health Eos	$146 - $322	124%
Wps	$147 - $268	125%
Cigna	$152 - $333	129%
Hfn	$152 - $333	129%
Preferred Network Access	$152 - $333	129%
The Alliance	$168 - $280	143%
Humana	$271 - $291	231%

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 $77.
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 Beloit Health System 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.