CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: The Children's Mercy Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $140
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at The Children's Mercy Hospital is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.19x the Medicare baseline. Located in 2401 Gillham Road, Kansas City, MO.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$140

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $115 (98%)
Insurance Median: $140 (119%)
Cash: $115 (98% of Medicare)
Ins. Median: $140 (119% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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%
Healthy Blue $95 - $116 81%
Quiktrip $95 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%
Humana $140 119%
Medica $140 119%
Nebraska Furniture Mart $141 120%
Orscheln $142 121%
Cigna $146 124%
Coventry Health Care Of Kansas $153 130%
Wellfit/Centrus $153 130%
Centivo $158 134%
Mercy Health $175 149%
Coxhealth Network $178 151%
National Preferred Provider Network $211 179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2401 Gillham Road, Kansas City, MO 64108
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens