CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Columbus Community Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $346
  • Cash Discount Price: $254
  • vs. Medicare Baseline: 2.94x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Columbus Community Hospital is $346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 2.94x the Medicare baseline. Located in 1515 Park Ave, Columbus, WI.
Cash / Self-Pay
$254

Average discount available for prompt cash payment at this facility.

Insurance Median
$346

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: $254 (216%)
Insurance Median: $346 (294%)
Cash: $254 (216% of Medicare)
Ins. Median: $346 (294% 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 294% of the Medicare baseline (a markup of 194%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Dean Health Plan $134 - $401 114%
Icare $134 114%
My Choice Wisconsin $134 - $346 114%
Quartz $134 - $303 114%
Security Health Plan $134 - $344 114%
UnitedHealthcare $134 - $383 114%
Cigna $276 235%
Alliance $335 285%
Health Payment Systems $346 294%
Blue Cross Blue Shield $355 302%
Trilogy $378 322%
Wps $388 330%
Healtheos $401 - $429 341%
First Health $406 345%
Humana $415 353%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1515 Park Ave, Columbus, WI 53925
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals