Office visit, established patient (20-29 min)
Facility: Bob Wilson Memorial Hospital
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $178
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.87x 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 |
|---|---|---|
| Blue Cross Blue Shield | $178 | 187% |
Consumer Guidance & Cost Commentary
For this office visit at Bob Wilson Memorial Hospital in Ulysses, Kansas, the negotiated rate for an established patient visit (20–29 minutes) is $178.00, which is significantly higher than the state average of $95.19. While this facility is a Critical Access Hospital owned by a voluntary non-profit church, the price transparency data indicates that cash payments and negotiated rates are currently null, meaning there is no publicly disclosed cash price or median paid amount to compare against. Because commercial negotiated rates often include administrative overhead and contract premiums, patients with high-deductible plans should verify if paying cash directly could result in a lower total cost, provided the facility offers a self-pay or prompt-pay discount.
It is important to understand that the $178.00 rate represents the maximum amount an in-network insurer like Blue Cross Blue Shield may pay, not necessarily the final amount you owe. If you are out-of-network, you could face balance billing, where the hospital bills you for the difference between their full chargemaster rate and what your insurance allowed, though the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. To ensure you are not overcharged, always request an itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. If you choose to pay out-of-pocket, ask specifically about prompt-pay discounts upfront to avoid automatic claims submission that might void any cash savings.