New patient office visit (30-44 min)
Facility: Kiowa County Memorial Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $125
- Cash Discount Price: $119
- vs. Medicare Baseline: 1.06x 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 - $445 | 32% |
| Celtic Comml Exchange-All Other Plans | $68 - $445 | 58% |
| Providrs Care/Wppa-All Plans | $68 - $322 | 58% |
| UnitedHealthcare | $68 - $434 | 58% |
| Humana | $73 - $445 | 62% |
| Medicaid / KanCare | $85 - $215 | 72% |
| Health Partners Of Ks-All Plans | $92 - $189 | 78% |
| Medica Prime Mcare Cost-All Plans | $93 - $445 | 79% |
| Aetna | $93 - $445 | 79% |
Consumer Guidance & Cost Commentary
For CPT code 99203, representing a new patient office visit lasting 30 to 44 minutes, Kiowa County Memorial Hospital in Greensburg, KS, lists a gross charge of $140.00. While the facility's cash median rate is $119.00 and the median negotiated rate for in-network payers is $125.00, these figures are significantly higher than the Medicare benchmark of $117.57. The data indicates that commercial rates for this service are approximately 110% of the Medicare amount, which aligns with the typical range where fair pricing is often defined as 120% to 150% of Medicare. Patients should note that while cash payments may appear cheaper than some insurance negotiated rates, the actual out-of-pocket cost depends heavily on individual plan deductibles and copays. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When using insurance, patients should be aware that negotiated rates vary widely across different payers, ranging from a low of $38 for Blue Cross Blue Shield to a high of $445 for several other plans. Because these rates are contractually agreed upon, they serve as a ceiling that prevents billing the full chargemaster price, though they often remain inflated by administrative costs associated with claims processing. If a patient receives care from an out-of-network provider at this in-network facility, the No Surprises Act generally protects them from balance billing for emergency and non-emergency services, but unexpected ancillary services like lab work could still trigger additional charges. To ensure