CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Black River Memorial Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $131
Cash Discount Price: $158
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Black River Memorial Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.11x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

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: $158 (134%)

Insurance Median: $131 (111%)

Cash: $158 (134% of Medicare)

Ins. Median: $131 (111% 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
Corvel	$13 - $274	11%
Security Health Plan	$18 - $420	15%
Blue Cross Blue Shield	$19 - $396	16%
The Alliance	$19 - $432	16%
Humana	$20 - $418	17%
Quartz Health Solutions, Inc	$20 - $410	17%
Triology Health Solutions	$20 - $428	17%
Association Benefits Solution	$21 - $428	18%
Cigna	$21 - $436	18%
Cofinity	$21 - $436	18%
Coventry Health Care	$21 - $436	18%
Custom Benefit Administrators	$21 - $436	18%
Family Health Center Of Marshfield	$21 - $428	18%
First Health Group Corporation	$21 - $428	18%
Group Health Cooperative Of Eau Claire	$21 - $436	18%
Healthpartners, Inc.	$21 - $436	18%
Medica	$21 - $420	18%
Multiplan	$21 - $446	18%
Provider Network Of America	$21 - $428	18%
UnitedHealthcare	$21 - $424	18%
Wisconsin Physicians Service Insurance Corp	$21 - $436	18%
Chorus	$22 - $441	19%
My Choice Wisconsin, Inc.	$60 - $106	51%

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 $158.
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 Black River Memorial 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.