Office visit, established patient (20-29 min)
Facility: Via Christi Hospital Wichita St Teresa, Inc
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $70
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.74x 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 |
|---|---|---|
| Early Detection Works | $70 | 74% |
Consumer Guidance & Cost Commentary
This office visit for an established patient at Via Christi Hospital Wichita St Teresa, Inc, in Wichita, KS, has a median negotiated rate of $70.00, which matches the lowest and highest reported amount from one insurance plan, Early Detection Works. While the facility is a voluntary non-profit acute care hospital with a strong 4-star rating, the data indicates that cash and median paid values are not currently available for this specific service. Because cash prices are often lower than insurance negotiated rates, patients with high-deductible plans may find it financially beneficial to pay out-of-pocket directly, provided they confirm the "self-pay" or "prompt-pay" discount rates with the hospital before scheduling.
For transparency, this service is priced at 70% of the Medicare benchmark amount of $95.19, suggesting a rate that aligns with fair pricing standards rather than the inflated chargemaster lists often used for comparison. Although specific county or state average data was not provided in this report, the absence of cash and median paid figures highlights the importance of requesting an itemized billing audit if you receive a surprise bill. Under federal protections like the No Surprises Act, you are generally shielded from balance billing for out-of-network services at in-network facilities, and any unexpected charges should be disputed in writing to ensure accuracy. Always verify your deductible status and ask for a full line-by-line statement before finalizing payment to avoid errors or double-billing.