Office visit, established patient (20-29 min)
Facility: Cottonwood Springs Llc
Billing Code: 99213 (CPT)
- CPT Billing Code: 99213
- Insurance Median: $78
- Cash Discount Price: $800
- vs. Medicare Baseline: 0.82x 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 |
|---|---|---|
| First Health | $64 | 67% |
| Multiplan/Phcs/Beech Street | $68 | 71% |
| Compsych | $75 | 79% |
| Healthsmart | $80 | 84% |
| Provider Networks Of America | $85 | 89% |
| Velocity National Provider Network | $85 | 89% |
Consumer Guidance & Cost Commentary
For this office visit with an established patient at Cottonwood Springs Llc in Olathe, KS, the cash price is $800.00, which is lower than the facility's gross charge of $1,000.00. While the data does not provide a specific county or state average for comparison, the cash rate represents a direct discount from the listed price. Patients with high-deductible plans may find paying this cash price upfront more cost-effective than using insurance, as the negotiated rates for in-network payers range from $64 to $85, which could result in higher out-of-pocket costs if the patient's deductible has not yet been met. It is important to verify your specific plan details before scheduling to ensure you understand your financial responsibility.
The facility offers a median negotiated rate of $78.00 for this service, though the data indicates no median paid amount was recorded. Because this is a psychiatric facility, patients should proactively ask about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees. If you receive a bill that includes charges for services not rendered or unbundled components, you have the right to request a formal itemized billing audit to identify errors. Additionally, if you are ever billed for out-of-network services at an in-network facility, the No Surprises Act may protect you from balance billing, so you should dispute any unexpected charges with your insurer rather than paying immediately.