CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Jamaica Hospital Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $90
Cash Discount Price: $448
vs. Medicare Baseline: 0.77x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Jamaica Hospital Medical Center is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $448. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.77x the Medicare baseline. Located in 89Th Avenue and Van Wyck Expressway, Jamaica, NY.

Cash / Self-Pay

$448

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $448 (381%)

Insurance Median: $90 (77%)

Cash: $448 (381% of Medicare)

Ins. Median: $90 (77% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Ghi	$35 - $80	30%
Healthfirst	$68	58%
Fidelis	$76 - $80	65%
Aetna	$80 - $238	68%
Beacon Health Strategies	$80	68%
Centerlight Healthcare	$80	68%
Empire	$80 - $259	68%
Hip	$80 - $610	68%
Metroplus	$80 - $88	68%
UnitedHealthcare	$80 - $220	68%
Elderplan	$81	69%
Vns	$81	69%
Wellcare of Ny	$83	71%
Humana	$84	71%
Senior Whole Health	$84	71%
Hamaspik Choice	$92	78%
Magnacare	$92 - $1,485	78%
Hotel Trades Council	$100 - $1,912	85%
Emblemhealth	$131	111%
United Behavioral Health	$138 - $159	117%
World Trade Center Program	$141	120%
Centers Plan for Healthy Living	$200	170%
Empire Blue Priority	$220	187%
Cigna	$289	246%
Villagecaremax	$313	266%
Oscar	$438	373%
Centivo	$456	388%
Create Health Plan	$1,414	1203%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $448.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Jamaica Hospital Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.