CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Upland Hills Health

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $194
Cash Discount Price: $268
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Upland Hills Health is $194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $268. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.65x the Medicare baseline. Located in 800 Compassion Way, Dodgeville, WI.

Cash / Self-Pay

$268

Average discount available for prompt cash payment at this facility.

Insurance Median

$194

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: $268 (228%)

Insurance Median: $194 (165%)

Cash: $268 (228% of Medicare)

Ins. Median: $194 (165% 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
Humana	$74 - $457	63%
UnitedHealthcare	$104 - $158	88%
Alliance	$107 - $287	91%
Blue Cross Blue Shield	$142 - $416	121%
Icare	$142	121%
Medical Associates	$142 - $380	121%
Mhs	$142	121%
Security Health Plan	$142	121%
Dean Health Plan	$143 - $353	122%
Wps	$309 - $319	263%
Ghc Of Sc Wi	$345	293%
Quartz	$350	298%
Cigna	$378 - $423	322%
Multiplan	$446	379%

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 $268.
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 Upland Hills Health 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.