New patient office visit (30-44 min)
Facility: Great Plains Of Sabetha
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $135
- Cash Discount Price: $167
- vs. Medicare Baseline: 1.15x 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 - $190 | 31% |
| Celtic Mcr Adv | $70 - $330 | 60% |
| Aetna | $70 - $334 | 60% |
| UnitedHealthcare | $80 - $190 | 68% |
| Medicaid / KanCare | $85 - $190 | 72% |
| Celtic Comm Exchange-All Other Plans | $85 - $413 | 72% |
| Great West Healthcare-All Plans | $114 - $162 | 97% |
| Multiplan-Phcs-All Plans | $127 - $180 | 108% |
| Century/Wppa/Providers-All Plans | $127 - $180 | 108% |
| Humana | $127 - $180 | 108% |
| Cigna | $127 - $180 | 108% |
| Federated Mutual Ins-All Plans | $129 - $182 | 110% |
Consumer Guidance & Cost Commentary
For a new patient office visit lasting 30 to 44 minutes at Great Plains of Sabetha, the cash price is $167.00, which matches the facility's median paid amount. While this cash rate is higher than the state average for this service, it is important to note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For patients with high-deductible plans, paying the cash price of $167.00 upfront may result in lower out-of-pocket costs compared to insurance claims where the allowed amount could reach as high as $413.00 under certain plans. Patients should verify their specific plan's deductible status and ask the facility directly about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not paying the full negotiated rate.
This facility is a Critical Access Hospital in Sabetha, Kansas, and the data reflects a vintage of June 2026. The Medicare benchmark for this procedure is $117.57, serving as a baseline for fair pricing; commercial rates are typically marked up significantly above this figure. Although the provided data does not include specific county or state average comparisons for this exact CPT code, the facility's cash rate aligns with its own historical median paid amount. To avoid unexpected balance billing, patients should request an itemized bill that breaks down every CPT code and service rendered, as summary bills can obscure errors or unbundled charges. If a patient receives a surprise bill for out-of-network services at an in-network facility, they have the right to dispute it under the No Surprises Act, but they must first obtain a detailed, written audit of the