New patient office visit (30-44 min)
Facility: Scott County Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $199
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.69x 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 |
|---|---|---|
| UnitedHealthcare | $88 - $228 | 75% |
| Humana | $93 - $101 | 79% |
| Blue Cross Blue Shield | $101 | 86% |
| Wppa | $133 - $1,200 | 113% |
| Aetna | $199 - $216 | 169% |
Consumer Guidance & Cost Commentary
For a new patient office visit lasting 30 to 44 minutes at Scott County Hospital in Scott City, KS, the Medicare benchmark rate is $117.57. This facility, a Critical Access Hospital, charges 170% of the Medicare amount, which aligns with the typical commercial markup range of 120% to 150% often considered fair. While the facility's median negotiated rate is $199.00, commercial payers show significant variation; for instance, UnitedHealthcare plans range from $88 to $228, and WPPA plans can reach as high as $1,200. Patients should be aware that cash-pay options are not listed for this service, but it is always advisable to ask the billing department directly about self-pay or prompt-pay discounts, which can sometimes result in lower costs than the standard negotiated rates, especially for those with high-deductible plans.
To ensure you are receiving the most accurate pricing, request a full itemized bill rather than accepting a summary invoice that may obscure individual charges or unbundled services. If you receive a bill, verify that it lists specific CPT codes and does not include charges for services that were never rendered or supplies that were cancelled. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, you should still review your specific plan details to confirm your deductible status before scheduling, as paying out of pocket without meeting your deductible could result in higher out-of-pocket expenses than expected.