New patient office visit (30-44 min)
Facility: Saint Luke'S South Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $110
- Cash Discount Price: $125
- vs. Medicare Baseline: 0.94x 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 | $44 - $95 | 37% |
| Transplants-Case Rates [5750] | $73 - $208 | 62% |
| Cigna | $76 - $146 | 65% |
| Blue Cross Blue Shield | $94 - $139 | 80% |
| Medicaid / KanCare | $110 - $165 | 94% |
| Aetna | $114 - $198 | 97% |
| First Health [5512] | $123 | 105% |
| Commercial-Contracted [8000] | $156 | 133% |
Consumer Guidance & Cost Commentary
For this new patient office visit (30-44 minutes) at Saint Luke's South Hospital in Overland Park, KS, the cash median price is $125.00, which is lower than the facility's negotiated rates of $110.00 and the gross charge of $208.00. While the facility is an acute care hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance plans often pay significantly higher amounts than cash prices due to administrative overhead and contract dynamics. For instance, Aetna's negotiated rate of $198.00 and UnitedHealthcare's range of $44.00 to $95.00 illustrate how insurance payments can vary widely. If you have a high-deductible plan, paying the cash price of $125.00 upfront might be more cost-effective than waiting for insurance to process a claim, especially since the cash rate is below the facility's median negotiated rate.
To avoid unexpected costs, it is crucial to understand that balance billing can occur if you are out-of-network, though the No Surprises Act protects you from such bills for emergency care and non-emergency services at in-network facilities. If you do receive a balance bill, do not pay it immediately; instead, request an itemized billing audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, always ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling your visit, as paying in full upfront can often reduce the total amount owed by bypassing the costly insurance claims process.