New patient office visit (30-44 min)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $88
- Cash Discount Price: $103
- vs. Medicare Baseline: 0.75x 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 |
|---|---|---|
| UnitedHealthcare | $78 - $85 | 66% |
| Medicaid / KanCare | $81 - $88 | 69% |
| Aetna | $81 - $88 | 69% |
| Tricare | $97 | 83% |
| Blue Cross Blue Shield | $109 - $115 | 93% |
| Providrs Care | $111 | 94% |
Consumer Guidance & Cost Commentary
For this New patient office visit (30-44 min) at Ascension Via Christi Hospital Manhattan, Inc, the cash median price is $103.00, which is significantly lower than the facility's negotiated rates. While commercial payers like UnitedHealthcare and Aetna negotiate rates ranging from $78 to $115, and Medicaid/KanCare plans average between $81 and $88, the cash price offers a distinct advantage for those without insurance or with high-deductible plans. Patients should be aware that insurance negotiated rates often include administrative overhead and can exceed the cash price; therefore, it is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can sometimes result in a lower total cost than using an in-network plan.
The facility's pricing is also contextualized by the Medicare benchmark, which serves as a scientifically validated baseline for healthcare costs. With a Medicare amount of $117.57, the cash price of $103.00 is lower than the federal government's calculated cost basis, whereas the facility's median negotiated rate of $88.00 sits below the Medicare amount but above the cash price. This demonstrates that while commercial contracts protect members from the full chargemaster gross, they do not always represent the lowest possible price. To ensure you are not overpaying, always request an itemized bill to verify that no unbundled codes or services not rendered are included, and remember that the No Surprises Act protects you from balance billing for out-of-network services at this in-network facility.