New patient office visit (30-44 min)
Facility: William Newton Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $132
- Cash Discount Price: $198
- vs. Medicare Baseline: 1.12x 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 | $64 - $132 | 54% |
| Blue Cross Blue Shield | $68 - $136 | 58% |
| Ambetter / Centene | $78 - $378 | 66% |
| UnitedHealthcare | $80 - $340 | 68% |
| Providrs Care Nexus | $136 - $231 | 116% |
| Providrs Care - All Other Plans | $155 - $264 | 132% |
Consumer Guidance & Cost Commentary
For this New patient office visit (30-44 min) at William Newton Hospital in Winfield, KS, the cash price is $198.00, which matches the facility's median paid amount. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates vary significantly by insurer, ranging from $64 to $378 across six payers. It is important to note that commercial negotiated rates are often higher than cash prices due to administrative costs and contract structures; therefore, patients with high-deductible plans may find paying the full cash price of $198.00 cheaper than their insurance allowing a higher negotiated amount. Before scheduling, you should verify your specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost.
When reviewing your bill, be aware that summary invoices may obscure individual charges, so always request a detailed, itemized statement to ensure accuracy. Additionally, while the No Surprises Act protects you from balance billing for emergency services at in-network facilities, it is crucial to check if any ancillary services were out-of-network and whether a formal audit is needed if you receive unexpected charges. For pricing context, the facility's cash rate is 1.1 times the Medicare benchmark of $117.57, and the median negotiated rate of $132.00 represents the average amount insurers pay. Since commercial rates often include significant markups compared to the federal baseline, comparing your specific allowed amount to the Medicare rate provides a clearer picture of fair pricing than looking at the hospital's gross charges.