Office visit, established patient (20-29 min)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $105
- Cash Discount Price: $90
- vs. Medicare Baseline: 1.10x 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 $95.19 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 |
|---|---|---|
| UnitedHealthcare | $57 - $150 | 60% |
| Blue Cross Blue Shield | $64 - $67 | 67% |
| Providers Care (Wppa)-All Plans | $140 - $210 | 147% |
Consumer Guidance & Cost Commentary
For this office visit with an established patient at the Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash price of $90.00 is notably lower than the state average of $113.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Blue Cross Blue Shield range from $57 to $210, patients should be aware that cash payments can sometimes result in lower out-of-pocket costs if their insurance deductible has not yet been met. The facility offers a prompt-pay discount for those who settle their bill upfront, which can further reduce the final amount owed compared to the standard negotiated rates.
To ensure you are not overcharged, it is essential to request an itemized billing audit before paying any invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you receive a balance bill for an out-of-network service, you may be entitled to protections under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Always verify your specific plan details and ask the hospital directly about self-pay or prompt-pay discounts prior to scheduling your appointment to avoid unexpected financial burdens.