New patient office visit (30-44 min)
Facility: Fredonia Regional Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $89
- Cash Discount Price: $99
- vs. Medicare Baseline: 0.76x 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 |
|---|---|---|
| Aetna | $50 - $89 | 43% |
| Meritain-All Plans | $89 | 76% |
| UnitedHealthcare | $89 | 76% |
| Cigna | $89 | 76% |
| Reserve National-All Plans | $89 | 76% |
| Blue Cross Blue Shield | $101 - $152 | 86% |
| Veterans Programs - All Plans | $152 | 129% |
Consumer Guidance & Cost Commentary
For a new patient office visit lasting 30 to 44 minutes at Fredonia Regional Hospital in Fredonia, KS, the cash price is $99.00, which matches the facility's negotiated rate for most major payers. While the Medicare benchmark for this service is $117.57, indicating that the cash price is 84% of the federal baseline, commercial insurance plans such as Aetna and Blue Cross Blue Shield negotiate rates ranging from $50 to $152. Patients with high-deductible plans may find paying the $99.00 cash price more cost-effective than relying on insurance, as the negotiated rates for some carriers exceed the cash amount. It is advisable to confirm with the hospital whether "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill by bypassing administrative processing fees.
To ensure you are receiving the most accurate pricing, always request a full itemized bill rather than accepting a summary invoice that obscures individual charges. Since over 80% of hospital bills contain errors, such as unbundled codes or services not rendered, a line-by-line review is essential before negotiating or paying. Additionally, while the facility is a Critical Access Hospital owned by the local government, patients should verify their specific plan's deductible status before scheduling, as paying the negotiated rate without meeting the deductible could result in higher out-of-pocket costs than the cash price. Comparing this facility's rates to the state average helps identify fair pricing, but the most reliable benchmark remains the Medicare amount, which reflects the true cost of care delivery.