New patient office visit (30-44 min)
Facility: Morris County Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $81
- Cash Discount Price: $87
- vs. Medicare Baseline: 0.69x 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 |
|---|---|---|
| Blue Cross Blue Shield | $36 - $57 | 31% |
| Va Ccn-All Plans | $57 | 48% |
| Choice Care Mcr Adv-All Plans | $57 | 48% |
| UnitedHealthcare | $57 - $145 | 48% |
| Coventry Mcr | $57 | 48% |
| Cigna | $105 | 89% |
| Multiplan-All Plans | $130 | 111% |
| Coventry Comm-All Other Plans | $130 | 111% |
| Aetna | $130 | 111% |
| Providrs Care (Wppa)(Nexus)-All Plans | $218 | 185% |
Consumer Guidance & Cost Commentary
For a new patient office visit lasting 30 to 44 minutes, Morris County Hospital in Council Grove, Kansas, lists a cash median price of $87.00, which is lower than the facility's negotiated rate of $83.00 and significantly below the gross charge of $145.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates can sometimes exceed cash prices; for instance, UnitedHealthcare's range spans from $57 to $145, meaning a patient with a high deductible might save money by paying the cash price directly. To maximize savings, it is essential to contact the hospital directly to confirm "self-pay" or "prompt-pay" discounts, as these upfront payment incentives can reduce the total cost by bypassing administrative fees and claims processing delays.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this procedure is $117.57, and the facility's negotiated rate of $81.00 falls below this federal baseline, indicating a pricing structure that aligns with fair market value rather than a markup. If a patient receives an itemized bill that appears higher than these figures, they should request a detailed line-by-line audit to identify potential errors such as unbundled codes or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through formal written disputes. By understanding the difference between the gross charge, the Medicare rate, and the actual negotiated or cash price, consumers can make informed decisions and avoid unnecessary financial burden.