Office visit, established patient (20-29 min)
Facility: Labette Health
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $76
- Cash Discount Price: $74
- vs. Medicare Baseline: 0.80x 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 |
|---|---|---|
| Ambetter / Centene | $26 - $27 | 27% |
| Montgomery County | $34 - $104 | 36% |
| Medicaid / KanCare | $47 - $48 | 49% |
| Aetna | $57 | 60% |
| Kansas Superior Select | $62 | 65% |
| Multiplan | $88 - $90 | 92% |
| Health Partners Of Kansas, Inc | $94 - $95 | 99% |
| Choicecare (First Health Network) | $94 - $95 | 99% |
| Blue Cross Blue Shield | $133 | 140% |
| UnitedHealthcare | $139 - $226 | 146% |
Consumer Guidance & Cost Commentary
For this office visit to an established patient at Labette Health in Parsons, KS, the facility's cash price of $74.00 is notably lower than the state average for this service. While the facility is a government-owned acute care hospital, its cash rate sits below the median negotiated rate of $76.00, which is often higher due to administrative costs and insurance contract structures. Patients with high-deductible plans may find paying the cash price directly more cost-effective than using insurance, as the negotiated rates for in-network payers like UnitedHealthcare and Blue Cross Blue Shield can significantly exceed the cash amount. It is important to note that while the cash price is competitive, patients should verify if the facility offers additional "self-pay" or "prompt-pay" discounts before scheduling to ensure they are receiving the lowest possible rate.
The data indicates that commercial insurance rates vary widely depending on the payer, with some plans like Ambetter / Centene paying as low as $26, while others like UnitedHealthcare pay up to $226. This disparity highlights the importance of checking your specific plan's allowed amount before receiving care, as the facility's negotiated rates are not uniform across all insurers. Although the No Surprises Act protects patients from balance billing for emergency services at in-network facilities, it is crucial to request an itemized bill to identify any unbundled codes or services not rendered, which can lead to unexpected charges. Consumers should avoid accepting summary bills as final invoices and instead demand a detailed line-by-line statement to ensure accuracy, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.