New patient office visit (30-44 min)
Facility: Mitchell County Hospital Health Systems
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $135
- Cash Discount Price: $139
- vs. Medicare Baseline: 1.15x 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 |
|---|---|---|
| First Health-All Plans | $34 - $180 | 29% |
| Aetna | $34 - $180 | 29% |
| Triwest Well Mark All Plans | $34 - $181 | 29% |
| UnitedHealthcare | $38 - $202 | 32% |
| Blue Cross Blue Shield | $38 | 32% |
| Auxiant-All Plans | $111 - $142 | 94% |
| Pref Hlth Care Sytms Comm - All Plans | $135 | 115% |
| Health Partners Ks-All Plans | $139 - $148 | 118% |
| Multiplan Ppo - All Plans | $142 | 121% |
| Phc Leased Ntwrk Access - All Plans | $142 | 121% |
| Cigna | $148 | 126% |
Consumer Guidance & Cost Commentary
For this New patient office visit (30-44 min) at Mitchell County Hospital Health Systems in Beloit, KS, the cash price is $139.00, which is lower than the facility's gross charge of $155.00. While the median negotiated rate across 11 payers is $135.00, patients with high-deductible plans may find paying cash directly more cost-effective, as the cash price is already below the average negotiated amount. It is important to note that while the facility is a Critical Access Hospital with a government-local ownership structure, commercial rates can still vary significantly; for instance, UnitedHealthcare's range extends up to $202, whereas Blue Cross Blue Shield has a fixed rate of $38. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final cost by bypassing administrative fees associated with insurance claims.
The facility's pricing is benchmarked against Medicare, which sets a baseline of $117.57 for this procedure. The cash price of $139.00 represents a markup of approximately 18% over the Medicare rate, aligning with fair pricing standards that typically range between 120% and 150% of Medicare. Although the data does not provide specific state or county average comparisons for this specific CPT code, the facility's cash rate remains competitive relative to its gross charges and the median negotiated rates observed across major payers like Aetna and First Health-All Plans. Consumers should be aware that balance billing is largely prohibited for emergency care and non-emergency services at