New patient office visit (30-44 min)
Facility: Stanton County Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $207
- Cash Discount Price: $190
- vs. Medicare Baseline: 1.76x 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 | $96 - $230 | 82% |
| Healthy Blue Mcaid | $207 | 176% |
| Healthy Blue Mcr Adv - All Other Plans | $238 | 202% |
Consumer Guidance & Cost Commentary
For a new patient office visit lasting 30 to 44 minutes at Stanton County Hospital in Johnson, KS, the cash price is $190.00, which matches the facility's cash median. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates for in-network payers like Blue Cross Blue Shield range from $96 to $230, and Healthy Blue plans see rates of $207. It is important to note that cash payments can sometimes be more cost-effective than insurance claims, particularly for patients with high deductibles, as the insurance negotiated rates often exceed the cash price. Additionally, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed if paid in full upfront.
This service is priced significantly higher than the Medicare benchmark, which is set at $117.57, with a comparison ratio of 1.8 times the Medicare rate. Although the data does not provide specific state or county average figures for this procedure, the Medicare rate serves as the federal baseline for evaluating pricing markup. Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, it is crucial to request an itemized bill before paying. If you receive a summary bill, you should demand a detailed, line-by-line statement to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.