New patient office visit (30-44 min)
Facility: Hamilton County Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $116
- Cash Discount Price: $131
- vs. Medicare Baseline: 0.99x 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 | $18 - $101 | 15% |
| First Health Coventry - All Plans | $106 - $116 | 90% |
| Cigna | $119 - $130 | 101% |
| UnitedHealthcare | $119 - $130 | 101% |
| Va Ccn - All Plans | $137 | 117% |
| Aetna | $233 - $366 | 198% |
Consumer Guidance & Cost Commentary
For this New patient office visit (30-44 min) at Hamilton County Hospital in Syracuse, KS, the cash price is $131.00, which matches the facility's median paid amount. While the facility is a Critical Access Hospital owned by the local government, the data does not provide specific county or state average figures for comparison. However, it is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. For instance, Aetna's negotiated range for this service spans from $233 to $366, which is significantly higher than the cash rate. Patients with high-deductible plans may find paying the cash price of $131.00 directly more affordable than having their insurance pay a negotiated rate that exceeds this amount, provided they have not yet met their deductible.
The Medicare benchmark for this service is $117.57, serving as a baseline for fair pricing. Commercial negotiated rates vary widely by payer, ranging from a low of $18 for Blue Cross Blue Shield to a high of $366 for Aetna, with the median negotiated rate across all payers at $116.00. Because the facility is in-network for all listed payers, the No Surprises Act protects patients from balance billing for emergency or non-emergency services from out-of-network providers at this location. To ensure you receive the best possible rate, we recommend asking the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final cost. Always request a full itemized bill before paying to verify that all charges are accurate and that no unbundled