New patient office visit (30-44 min)
Facility: Greenwood County Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $115
- Cash Discount Price: $110
- vs. Medicare Baseline: 0.98x 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% |
| Triwest - All Plans | $48 - $50 | 41% |
| Tricare | $57 - $59 | 48% |
| Choicecare Mcr Adv - All Plans | $57 - $59 | 48% |
| UnitedHealthcare | $57 - $118 | 48% |
| Integrated Health Plan - All Plans | $101 - $105 | 86% |
| First Health Ccn Network | $115 - $119 | 98% |
| Beech Street - All Plans | $115 - $119 | 98% |
| First Health - All Other Plans | $115 - $119 | 98% |
| Preferred Hs (Coventry) - All Plans | $122 - $126 | 104% |
| Principal Health Care Inc - All Plans | $128 - $133 | 109% |
| Amerigroup Mcaid-All Plans | $135 - $140 | 115% |
| Medicaid / KanCare | $135 - $140 | 115% |
| Providrs Care/Wppa - All Plans | $202 - $210 | 172% |
Consumer Guidance & Cost Commentary
For this new patient office visit (30-44 minutes) at Greenwood County Hospital in Eureka, Kansas, the cash price is $110, which is lower than the facility's negotiated rates with most insurance plans. While the cash rate is $110, the median negotiated rate across payers is $115, meaning patients with high-deductible plans might save money by paying cash upfront rather than using insurance, as the insurer's allowed amount often exceeds the cash price. It is important to note that the facility is a Critical Access Hospital with government-local ownership, and while the gross charge is $138, the actual amount billed to patients depends on their specific plan. Patients should always ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final bill further.
When evaluating this cost, it is helpful to compare it against the Medicare benchmark, which serves as a scientifically validated baseline for the true cost of care. The Medicare amount for this service is $117.57, and the facility's cash rate of $110 is slightly below this benchmark, indicating a fair price relative to federal standards. Although the data does not provide specific county or state average figures for comparison, the facility's cash rate remains competitive when viewed against the national average of 120% to 150% of Medicare for fair pricing. To ensure you are not overcharged, request an itemized bill that breaks down every CPT code and unit cost, avoiding summary bills that may hide errors or unbundled charges. If you receive a balance bill for out-of-network services, remember that the No Surprises Act protects you from