Office visit, established patient (20-29 min)
Facility: St. Catherine Hospital - Garden City
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $63
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.66x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $95.19 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.
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 | $59 - $63 | 62% |
| UnitedHealthcare | $59 - $63 | 62% |
| Blue Cross Blue Shield | $59 - $425 | 62% |
| Medicare (plans) | $59 - $63 | 62% |
| Kansas Health | $59 | 62% |
| Cigna | $59 - $63 | 62% |
| Kaiser | $59 - $63 | 62% |
| Humana | $59 - $63 | 62% |
| Innovage | $63 | 66% |
| Devoted Health | $63 | 66% |
Consumer Guidance & Cost Commentary
For the CPT code 99213 representing an office visit with an established patient (20-29 minutes) at St. Catherine Hospital in Garden City, KS, the negotiated rates for in-network payers range from $59 to $63, with a median of $63.00. This negotiated amount is significantly higher than the Medicare benchmark of $95.19, which serves as the federal baseline for the true cost of care. While commercial insurance contracts cap charges to protect members, these rates often exceed the actual cost basis, meaning patients with high-deductible plans might find paying the cash price directly more affordable. Since cash and median paid figures are not available in this dataset, patients should proactively contact the hospital to inquire about self-pay or prompt-pay discounts, which can reduce the total cost by 20% to 50% if settled upfront.
The facility operates as a voluntary non-profit church-owned acute care hospital, and while specific cash rates are not listed, the absence of a cash median suggests that commercial negotiated rates may be the primary billing mechanism for insured patients. It is important to note that while the No Surprises Act protects patients from balance billing for emergency services and non-emergency care from out-of-network providers at in-network facilities, patients should still review their itemized bills carefully. If a summary bill is received, patients should request a full line-by-line statement to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.