New patient office visit (30-44 min)
Facility: Children'S Mercy South
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $140
- Cash Discount Price: $115
- vs. Medicare Baseline: 1.19x 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 |
|---|---|---|
| UnitedHealthcare | $89 - $200 | 76% |
| Healthlink | $92 | 78% |
| Quiktrip | $95 | 81% |
| Healthy Blue | $95 - $116 | 81% |
| Medicaid / KanCare | $96 | 82% |
| Wppa Providrs Care | $106 | 90% |
| Health Midwest Comprehensive Care | $111 | 94% |
| American Healthcare Alliance | $116 | 99% |
| Home State Health | $116 | 99% |
| Aetna | $121 - $140 | 103% |
| Multiplan | $123 | 105% |
| Blue Cross Blue Shield | $129 - $163 | 110% |
| Medica | $140 | 119% |
| Humana | $140 | 119% |
| Nebraska Furniture Mart | $141 | 120% |
| Orscheln | $142 | 121% |
| Cigna | $146 | 124% |
| Wellfit/Centrus | $153 | 130% |
| Coventry Health Care Of Kansas | $153 | 130% |
| Centivo | $158 | 134% |
| Mercy Health | $175 | 149% |
| Coxhealth Network | $178 | 151% |
| National Preferred Provider Network | $211 | 179% |
Consumer Guidance & Cost Commentary
For this new patient office visit (30-44 minutes) at Children's Mercy South in Overland Park, KS, the facility's cash price of $115.00 is notably lower than the state average, which sits at $140.00. While many commercial payers negotiate rates that exceed this cash price—ranging from $89 to $211 depending on the insurance plan—patients with high-deductible plans may find paying cash upfront to be the most cost-effective option. This is because the negotiated rates charged by insurers often include administrative overhead and contract markups that push the final allowed amount well above the direct cash rate. To maximize savings, patients should verify their specific plan's negotiated rate before scheduling and ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the cost if the bill is settled in full within a short window.
The facility's negotiated rates vary significantly across payers, with the lowest allowed amount being $89 from UnitedHealthcare and the highest reaching $211 from the National Preferred Provider Network. When compared to the Medicare benchmark of $117.57, the cash price of $115.00 is slightly lower, suggesting a pricing structure that aligns closely with the federal cost baseline rather than the typical commercial markup. However, for those relying on insurance, it is crucial to understand that the "allowed amount" represents a contractual ceiling rather than the lowest possible price, as some in-network facilities may charge significantly less than others for the same service. Consumers should avoid assuming that being in-network guarantees the best price and should always request an itemized bill to ensure no errors or unb