New patient office visit (30-44 min)
Facility: Bob Wilson Memorial Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $135
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.15x 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 | $135 | 115% |
Consumer Guidance & Cost Commentary
For this New patient office visit (30-44 min) at Bob Wilson Memorial Hospital in Ulysses, KS, the negotiated rate is $135.00, which aligns exactly with the lowest and highest values reported for Blue Cross Blue Shield plans. This facility is a Critical Access Hospital owned by a voluntary non-profit church. While the data does not provide specific cash or median paid amounts, patients should be aware that cash-pay options can sometimes result in lower out-of-pocket costs if their insurance negotiated rate exceeds the cash price. Because this is a Critical Access Hospital, it may offer specific financial assistance or prompt-pay discounts for self-pay patients, so it is advisable to contact the billing department directly to inquire about "self-pay" rates or discounts for upfront payment before scheduling your appointment.
The Medicare benchmark for this service is $117.57, which serves as a baseline for evaluating the facility's pricing structure. The negotiated rate of $135.00 represents a 1.1x multiplier relative to the Medicare amount, indicating the commercial rate is slightly higher than the federal baseline. Since the data does not include state or county average comparisons, patients should rely on the Medicare benchmark to gauge the "true cost" of this procedure. If you receive a bill that exceeds the negotiated amount, it may be due to balance billing practices, though the No Surprises Act generally protects patients from such charges for emergency care or non-emergency services from out-of-network providers at in-network facilities. Always request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.