CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Phillips County Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $203
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 1.73x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Phillips County Hospital is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.73x the Medicare baseline. Located in 1150 State Street, Phillipsburg, KS.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$203

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $185 (157%)
Insurance Median: $203 (173%)
Cash: $185 (157% of Medicare)
Ins. Median: $203 (173% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $101 - $242 86%
Medicaid / KanCare $163 - $272 139%
UnitedHealthcare $163 - $272 139%
Health Partners-All Plans $163 - $272 139%

Consumer Guidance & Cost Commentary

For this New patient office visit (30-44 min) at Phillips County Hospital in Phillipsburg, KS, the cash price is $185.00, which is lower than the facility's negotiated rates of $203.00 and the median paid amount of $218.00. While the facility is a Critical Access Hospital with government-local ownership, patients should be aware that commercial insurance plans like Blue Cross Blue Shield, Medicaid/KanCare, UnitedHealthcare, and Health Partners-All Plans have negotiated rates ranging from $163 to $272. In many cases, paying cash upfront can be more cost-effective than using insurance if your deductible is high or if the insurance negotiated rate exceeds the cash price. We recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.

To ensure you are getting the best possible rate, it is important to compare this facility's pricing against the broader healthcare landscape. The facility's cash rate of $185.00 is lower than the state average for this service, making it a competitive option for self-pay patients. However, when using insurance, the allowed amounts vary significantly by payer, with some plans paying up to $272. Always verify your specific plan's allowed amount before scheduling to avoid unexpected costs. If you receive a bill that seems too high, request an itemized statement to review every charge line-by-line, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Disputing these errors in writing is often the most effective way to reduce medical debt.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1150 State Street, Phillipsburg, KS 67661
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals