New patient office visit (30-44 min)
Facility: Stevens County Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $148
- Cash Discount Price: $170
- vs. Medicare Baseline: 1.26x 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 | $36 - $38 | 31% |
| Humana | $63 | 54% |
| Aetna | $65 - $170 | 55% |
| First Health - All Plans | $153 | 130% |
| Wppa - All Plans | $162 | 138% |
| Medicaid / KanCare | $170 | 145% |
Consumer Guidance & Cost Commentary
For this new patient office visit (30-44 minutes) at Stevens County Hospital in Hugoton, KS, the cash price is $170.00, which matches the facility's gross charge and the Medicare benchmark of $117.57. While the facility is a Critical Access Hospital with a government-local ownership structure, the cash rate is 1.3 times the Medicare amount, indicating a markup typical of commercial pricing. It is important to note that for patients with high-deductible plans, paying the full cash price of $170.00 upfront may be more cost-effective than using insurance, as the median negotiated rate paid by insurers is $63.00, but this amount is often subject to deductibles and copays that could exceed the cash price. Patients should verify their specific plan's deductible status before scheduling to avoid unexpected out-of-pocket costs.
Commercial payers negotiate different rates for this service, with Blue Cross Blue Shield ranging from $36.00 to $38.00 and Aetna ranging from $65.00 to $170.00 across three plans. The median negotiated rate across all six payers is $148.00, which is lower than the cash price but higher than the Medicare benchmark. To minimize costs, patients should ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full before or shortly after the service. Additionally, since over 80% of hospital bills contain errors, patients should request a detailed, itemized statement rather than accepting a summary bill, and they