Review of medical records for care
Facility: Wamego Health Center
Billing Code: 90889 (CPT)
- CPT Billing Code: 90889
- Insurance Median: $30
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: N/A 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.
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 |
|---|---|---|
| Providrs Care | $30 | N/A |
Consumer Guidance & Cost Commentary
For the CPT code 90889, "Review of medical records for care," at Wamego Health Center in Wamego, KS, the facility's median negotiated rate is $30.00. This rate reflects the contractual agreement between the provider and insurance carriers, which serves as a ceiling to prevent billing the full chargemaster list price. While commercial negotiated rates often average 200% to 300% of Medicare benchmarks, this specific service shows a negotiated rate of $30.00, which is significantly lower than typical commercial markups. Patients should note that cash-pay options may offer further savings; if a patient has a high-deductible plan, paying the cash price directly could be cheaper than the insurance negotiated rate, provided the facility offers a self-pay discount. It is always advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can bypass the administrative overhead and claims processing costs that inflate insurance rates.
This service is categorized under Critical Access Hospitals, a facility type that often operates with specific reimbursement structures to support rural healthcare access. The data indicates that for this specific code, there is only one payer plan listed, with a low and high negotiated rate of $30.00 from Providrs Care. Because the facility is a voluntary non-profit, the pricing structure may differ from for-profit entities, but patients should remain vigilant regarding balance billing if they are out-of-network. Under the No Surprises Act, patients are protected from balance billing for emergency care and non-emergency services at in-network facilities, though unexpected charges can still occur from out-of-network ancillary services like labs or emergency physicians.