New patient office visit (30-44 min)
Facility: Amberwell Atchison Association
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $174
- Cash Discount Price: $298
- vs. Medicare Baseline: 1.48x 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 |
|---|---|---|
| Triwest - All Plans | $93 - $104 | 79% |
| Blue Cross Blue Shield | $96 - $101 | 82% |
| Humana | $127 - $224 | 108% |
| Ambetter / Centene | $144 - $162 | 122% |
| Aetna | $155 - $174 | 132% |
| Cigna | $155 - $174 | 132% |
| Centrus Health Direct - All Plans | $212 - $237 | 180% |
| Oscar - All Plans | $212 - $237 | 180% |
| Multiplan - All Plans | $220 - $246 | 187% |
| Superior Select Mcr Adv - All Plans | $224 | 191% |
| Wppa Providrs Care - All Plans | $254 - $284 | 216% |
Consumer Guidance & Cost Commentary
For a new patient office visit lasting 30 to 44 minutes at Amberwell Atchison Association in Atchison, KS, the facility's cash price is $298.00, which matches the cash median for this service. While the facility is a Critical Access Hospital owned by a voluntary non-profit, the negotiated rates vary significantly by insurer, ranging from $93 to $284 across 11 different plans. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures; for instance, the median negotiated rate is $174.00, yet many payers list higher maximums. Patients with high-deductible plans may find paying the cash price directly more affordable than having insurance cover a service where the allowed amount exceeds the cash rate, so it is advisable to ask the hospital specifically about self-pay or prompt-pay discounts before scheduling.
The Medicare benchmark for this procedure is $117.57, which serves as a reliable baseline for evaluating pricing fairness, as commercial rates are frequently marked up significantly above this federal cost basis. Although the data does not provide specific county or state average comparisons for this exact code, the facility's cash price of $298.00 is notably higher than the Medicare amount, illustrating the potential markup in commercial pricing. If you receive a bill that includes charges for services not rendered, unbundled codes, or items that were cancelled, you should request a full itemized audit rather than accepting a summary bill. Additionally, if you are concerned about balance billing from out-of-network providers, remember that the No Surprises Act protects you from being billed for emergency care or non-emergency services at