New patient office visit (30-44 min)
Facility: Overland Park Reg Med Ctr
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $310
- Cash Discount Price: $831
- vs. Medicare Baseline: 2.64x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 264% of the Medicare baseline (a markup of 164%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Blue Cross Blue Shield | $61 - $285 | 52% |
| Nhc Advantage | $89 - $235 | 76% |
| Healthyblue | $94 - $247 | 80% |
| Coventry | $103 - $497 | 88% |
| United | $118 - $557 | 100% |
| Humana | $138 - $172 | 117% |
| Aetna | $141 - $631 | 120% |
| Universal Healthcare | $164 - $433 | 139% |
| Coventry Kc Mo | $192 - $507 | 163% |
| College Park Family Care Center | $202 - $532 | 172% |
| Oha Network | $234 - $619 | 199% |
| Multiplan | $249 - $990 | 212% |
| Corvel Corporation | $305 - $804 | 259% |
| Focus Healthcare Mgmt, Inc | $352 - $928 | 299% |
| Cco, Inc. | $352 - $928 | 299% |
| Triwest Health Alliance | $352 - $928 | 299% |
Consumer Guidance & Cost Commentary
For this new patient office visit (30-44 minutes) at Overland Park Reg Med Ctr, the cash price is $831.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $117.57, reflecting a markup of 2.6 times the federal baseline. While the facility is a Proprietary Acute Care Hospital in Overland Park, KS (Zip 66215), patients should note that commercial negotiated rates vary widely by insurer, ranging from $61 to $990 across 16 different payers. Because administrative overhead and contract dynamics often inflate these negotiated amounts, paying cash upfront can sometimes result in a lower total cost than what an insurance plan would allow, particularly for those with high-deductible plans.
To minimize out-of-pocket expenses, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid in full before or shortly after the service. It is crucial to request a waiver of insurance submission to prevent automatic claims processing, which would void any cash discount and trigger the higher negotiated rates. Additionally, since over 80% of hospital bills contain errors, patients should request a full itemized audit rather than accepting a summary bill, ensuring no unbundled codes or services not rendered are charged. While the facility holds a 4-star rating, the primary focus for cost control remains verifying the specific allowed amount with your insurer and comparing it directly against the cash price before scheduling.