CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Kaleida Health

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$83

about 0.9× the $95 Medicare rate · typically $63–$105

modeled estimate · not a bill or quote

What this hospital charges insurers

$86

About the fair price

about $3 over the fair price · 0.9× Medicare

Medicare pays $95 Fair price $83 This hospital $86 Cash price $281 Hospital's list price $281

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $56 Priciest $86

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Office visit, established patient (20-29 min) is about $83 (about 0.9× the $95 Medicare rate). Kaleida Health charges insurers about $86, or about $281 in cash — about the fair price. Located in Buffalo, NY.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Aetna Blue Cross Blue ShieldCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$60 - $84	63%
Aetnamajor	$77	81%
Independent Health	$42 - $131	44%
MagnaCare	$77 - $137	81%
+ 4 smaller / regional plans	$74 - $139

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 281), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99213.

Insurance Before you use insurance

Call your insurance company to confirm Kaleida Health is in-network.
Ask your insurer whether prior approval is required for CPT code 99213.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Kaleida Health

Compare: Office visit, established patient (20-29 min) at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.