Office visit, established patient (30-39 min)

For this office visit with an established patient (30-39 minutes), the facility's cash price is $121.00, which is lower than the gross charge of $135.00. While the facility is a Critical Access Hospital in Satanta, KS, serving the 67870 zip code, the data indicates a median negotiated rate of $96.00 across 38 payers, which is significantly lower than the cash price. This suggests that for patients with high-deductible plans, paying cash might not be the most economical option, as the insurance negotiated rate could result in a lower out-of-pocket cost once deductibles are met. However, patients should verify their specific plan's deductible status before scheduling, as some commercial rates can exceed cash prices if the patient has not yet met their annual deductible threshold.

The facility's pricing is benchmarked against the Medicare rate of $135.60, showing a ratio of 0.7, which indicates the cash price is 30% below the Medicare amount. It is important to note that commercial negotiated rates often average 200% to 300% of Medicare, so a rate appearing lower than the cash price does not necessarily reflect the true cost baseline. Patients should be aware of the No Surprises Act protections, which ban balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, and should dispute any unexpected bills by requesting a formal audit rather than paying immediately. Additionally, since the facility is a Government-owned Hospital District, patients should inquire directly about self-pay or prompt-pay discounts, which can range from 20% to 5