New patient office visit (30-44 min)
Facility: Centura St. Catherine-Dodge City
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $75
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.64x 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 |
|---|---|---|
| Cigna | $75 | 64% |
| Kaiser | $75 | 64% |
| Medicare (plans) | $75 | 64% |
| Blue Cross Blue Shield | $75 - $119 | 64% |
| Kansas Health | $75 | 64% |
| Aetna | $75 | 64% |
| Humana | $75 | 64% |
Consumer Guidance & Cost Commentary
For the CPT code 99203, representing a new patient office visit lasting 30 to 44 minutes, the facility in Dodge City, KS, has a median negotiated rate of $75.00 across seven payers. This rate aligns with the lowest and highest values reported for this service among the listed insurers, including Cigna, Kaiser, and Medicare. When compared to the Medicare benchmark of $117.57, the negotiated rates are approximately 63% of the Medicare amount, indicating a significant discount relative to the federal baseline. While commercial negotiated rates often average 200% to 300% of Medicare, this facility's rates fall well below that typical range, suggesting a competitive pricing structure for in-network members.
Patients should be aware that cash-pay options or prompt-pay discounts may offer further savings, particularly if their insurance deductible has not yet been met. Although the data does not list a specific cash median, facilities frequently offer self-pay or prompt-pay reductions of 20% to 50% for upfront payments, bypassing the administrative costs associated with insurance claims processing. Before scheduling, it is advisable to contact the hospital directly to confirm the lowest possible self-pay rate and request a waiver of insurance submission to avoid automatic claims that could void these discounts. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can expect to pay only the negotiated or self-pay amount rather than the difference between the chargemaster and the insurer's allowed amount.