New patient office visit (30-44 min)
Facility: Girard Medical Center
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $157
- Cash Discount Price: $119
- vs. Medicare Baseline: 1.34x 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 | $38 - $247 | 32% |
| Medicare (plans) | $57 - $247 | 48% |
| Kansas Superior Select-All Plans | $57 - $247 | 48% |
| UnitedHealthcare | $57 - $426 | 48% |
| Humana | $57 - $247 | 48% |
| Aetna | $57 - $784 | 48% |
| Ambetter / Centene | $57 - $247 | 48% |
| Multiplan-All Plans | $100 - $414 | 85% |
| Uhhis-All Plans | $114 - $426 | 97% |
Consumer Guidance & Cost Commentary
For a new patient office visit lasting 30 to 44 minutes at Girard Medical Center in Girard, KS, the facility's cash median rate is $119.00, while the negotiated rate for commercial insurance plans averages $157.00. This negotiated amount is higher than the cash price, which can be beneficial for patients with high-deductible plans who have not yet met their out-of-pocket threshold, as their insurance may cover the full $157.00 rather than the lower cash rate. The facility's negotiated rate also compares favorably against state and county averages, with the lowest negotiated rate among payers starting at $38.00 and the highest reaching $784.00, highlighting significant variation depending on the specific insurance plan.
Patients should verify their specific plan's allowed amount before scheduling, as in-network status does not guarantee the lowest possible price; some commercial payers may negotiate rates significantly higher than the cash option. Additionally, if you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if settled upfront. It is also important to review your itemized bill carefully, as over 80% of hospital bills contain errors such as double-billing or unbundled codes, and you should dispute any discrepancies in writing before making a final payment.