New patient office visit (30-44 min)
Facility: Cheyenne County Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $112
- Cash Discount Price: $137
- vs. Medicare Baseline: 0.95x 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 |
|---|---|---|
| Blue Cross Blue Shield | $38 - $103 | 32% |
| Wppa - All Plans | $61 - $153 | 52% |
| Preferred Hc - All Plans | $65 - $162 | 55% |
| Cpm - All Plans | $65 - $162 | 55% |
| Midlands Choice - All Plans | $66 - $165 | 56% |
| Unicare - All Plans | $67 - $167 | 57% |
| Integrated Hp - All Plans | $67 - $167 | 57% |
| Ppo Next - All Plans | $67 - $167 | 57% |
| Health Partners - All Plans | $67 - $167 | 57% |
| Tricare | $68 - $289 | 58% |
| Childrens Mercy - All Plans | $68 - $170 | 58% |
| Healthy Blue Mcaid - All Other Plans | $68 - $170 | 58% |
| UnitedHealthcare | $68 - $289 | 58% |
| Healthwave Mcaid - All Plans | $68 - $170 | 58% |
| Firstguard - All Plans | $75 - $136 | 64% |
| Choice Care - All Plans | $78 - $289 | 66% |
| First Health - All Plans | $78 - $119 | 66% |
| Providers Care-All Plans | $79 - $255 | 67% |
| Healthy Blue Mcr Adv | $80 - $289 | 68% |
| Aetna | $80 - $289 | 68% |
Consumer Guidance & Cost Commentary
For CPT code 99203, representing a new patient office visit lasting 30 to 44 minutes, the facility's cash median rate is $137.00, while the negotiated rate for in-network insurance is $112.00. This cash price is notably higher than the facility's own negotiated rate, which is a common occurrence when commercial insurance contracts include administrative overheads that inflate the baseline price by 20% to 40%. For patients with high-deductible plans, paying the cash price of $137.00 upfront may actually be more cost-effective than relying on insurance, as the insurer's allowed amount could exceed the cash rate. It is important to verify your specific plan's deductible status before scheduling, as paying the negotiated rate without meeting your deductible could result in higher out-of-pocket costs than paying cash directly.
The facility's pricing for this service aligns closely with the broader market, with the negotiated rate of $112.00 matching the median negotiated amount across all payers. While the gross charge listed is $112.00, the actual amount paid by insurers varies significantly, ranging from a low of $38 to a high of $289 depending on the specific insurance plan, with the lowest range observed for Blue Cross Blue Shield. Medicare serves as a critical benchmark for evaluating these rates, with the Medicare amount for this code set at $117.57. Since fair pricing is typically defined as 120% to 150% of the Medicare rate, the facility's negotiated rate falls within the expected range for commercial coverage. Patients should always request an itemized bill