New patient office visit (30-44 min)
Facility: Mcpherson Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $226
- Cash Discount Price: $203
- vs. Medicare Baseline: 1.92x 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 $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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $60 | 51% |
| UnitedHealthcare | $68 - $720 | 58% |
| Wellcare Mcr Adv - All Plans | $68 | 58% |
| Va Ccn - All Plans | $68 | 58% |
| Healthy Blue Mcr Adv | $68 | 58% |
| Humana | $68 | 58% |
| Blue Cross Blue Shield | $68 | 58% |
| Ambetter / Centene | $68 - $78 | 58% |
| Aetna | $82 - $720 | 70% |
| Multiplan - All Plans | $84 - $648 | 71% |
| Medicaid / KanCare | $85 - $720 | 72% |
| Health Blue Mcaid - All Other Plans | $86 - $734 | 73% |
| Wppa - All Plans | $162 - $504 | 138% |
| Medical Associates - All Plans | $174 - $540 | 148% |
| Central Plains - All Plans | $174 - $540 | 148% |
| Christian Health Aid - All Plans | $186 - $576 | 158% |
| Health Partners - All Plans | $220 - $684 | 187% |
| Cigna | $220 - $684 | 187% |
| First Health - All Plans | $220 - $684 | 187% |
Consumer Guidance & Cost Commentary
For a new patient office visit lasting 30 to 44 minutes at McPherson Hospital in McPherson, Kansas, the facility's cash median rate is $203.00, while the median negotiated rate across payers is $226.00. This cash price is notably lower than the facility's gross charge of $274.00 and represents a significant discount compared to the Medicare benchmark of $117.57, with the cash rate being approximately 1.7 times the Medicare amount. Patients with high-deductible plans may find paying the cash median of $203.00 more cost-effective than relying on insurance, as many commercial payers have negotiated rates that exceed this cash price; for instance, Medicaid/KanCare plans have negotiated rates ranging from $82 to $720, while some private insurers like Aetna and Multiplan show ranges starting above $80. It is important to note that while the facility is a voluntary non-profit acute care hospital, the negotiated rates vary widely depending on the specific insurance plan and network tier, with some plans like Tricare showing a fixed rate of $60.00.
Before scheduling any appointments, patients should verify their specific plan's allowed amount, as assuming that being in-network guarantees the lowest possible price is a common pitfall; in-network rates can vary significantly between different carriers and even within the same carrier's different plan types. Additionally, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with