Office visit, established patient (20-29 min)
Facility: Neosho Memorial Regional Medical Center
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $62
- Cash Discount Price: $78
- vs. Medicare Baseline: 0.65x 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 $95.19 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 |
|---|---|---|
| Tricare | $23 - $57 | 24% |
| Medicare (plans) | $24 - $100 | 25% |
| Aetna | $24 - $100 | 25% |
| Humana | $24 - $100 | 25% |
| Blue Cross Blue Shield | $24 - $147 | 25% |
| Medadv_Uhc | $24 - $100 | 25% |
| Va_Ccn | $24 - $100 | 25% |
| Medadv_Allwell | $24 - $100 | 25% |
| Ambetter / Centene | $38 - $105 | 40% |
| Wppa_Providrscare | $62 - $154 | 65% |
| United | $62 - $155 | 65% |
| Coventry | $71 - $177 | 75% |
| Cigna | $71 - $177 | 75% |
| Hpk | $71 - $177 | 75% |
Consumer Guidance & Cost Commentary
For this office visit at Neosho Memorial Regional Medical Center in Chanute, KS, the cash price is $78.00, which is lower than the facility's negotiated rates for most major payers. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find the cash price more affordable than their insurance allowed amounts, which range from $23 to $177 depending on the carrier. It is important to note that commercial negotiated rates often include administrative overhead and claim processing costs, making the upfront cash price a potentially more efficient option for self-pay patients.
To minimize costs, patients should explicitly request a "prompt-pay" discount before scheduling or checking in, as hospitals often offer 20% to 50% reductions for upfront payment to avoid administrative delays and bad debt. Additionally, because the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients should review their itemized bill carefully to ensure no unexpected charges exist. Comparing the facility's cash rate to the Medicare benchmark of $95.19 reveals that the cash price is competitive, and patients are encouraged to verify their specific plan's deductible status and allowed amounts to determine the most cost-effective payment method.