New patient office visit (30-44 min)
Facility: Hodgeman County Health Center
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $194
- Cash Discount Price: $220
- vs. Medicare Baseline: 1.65x 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 - $101 | 82% |
| Triwest - All Plans | $176 | 150% |
| Medicaid / KanCare | $176 - $275 | 150% |
| UnitedHealthcare | $176 - $261 | 150% |
| Humana | $176 | 150% |
| Aetna | $220 | 187% |
| First Health - All Plans | $248 | 211% |
| Health Partners - All Plans | $261 | 222% |
| Wppa (Provdrscare) - All Plans | $261 | 222% |
Consumer Guidance & Cost Commentary
For a new patient office visit lasting 30 to 44 minutes at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash price is $220.00, which is lower than the negotiated rates paid by most major insurance payers listed in this report. While the facility is a government-owned Critical Access Hospital, patients should be aware that commercial insurance contracts often result in higher allowed amounts than self-pay rates; for instance, Blue Cross Blue Shield plans may see a negotiated rate between $96 and $101, while Medicaid/KanCare plans range from $176 to $275. Because cash payments can sometimes be cheaper than insurance reimbursement—especially for those with high deductibles or out-of-network scenarios—it is advisable to confirm the "self-pay" or "prompt-pay" discount before scheduling. The facility offers a cash price of $220.00, which aligns with the cash median for this service, but patients should verify if their specific plan's negotiated rate exceeds this amount to avoid paying more through insurance.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the facility's gross charges. The Medicare reimbursement rate for this code is $117.57, meaning the cash price of $220.00 represents a markup of approximately 1.7 times the Medicare amount. This benchmarking approach reveals the true cost baseline, as commercial negotiated rates often include administrative overhead and contract dynamics that inflate the price above the federal standard. If you receive a bill from an out-of-network provider or encounter unexpected charges, you have the right to dispute balance billing under the No Surprises Act,