CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Jamaica Hospital Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $73
  • Cash Discount Price: $330
  • vs. Medicare Baseline: 0.77x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Jamaica Hospital Medical Center is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $330. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.77x the Medicare baseline. Located in 89Th Avenue and Van Wyck Expressway, Jamaica, NY.
Cash / Self-Pay
$330

Average discount available for prompt cash payment at this facility.

Insurance Median
$73

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$95.19

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $95.19 (100%)
Cash / Self-Pay: $330 (347%)
Insurance Median: $73 (77%)
Cash: $330 (347% of Medicare)
Ins. Median: $73 (77% of 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.

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 - $64 37%
Healthfirst $54 57%
Fidelis $60 - $64 63%
Aetna $64 - $238 67%
Beacon Health Strategies $64 67%
Centerlight Healthcare $64 67%
Empire $64 - $259 67%
Hip $64 - $610 67%
Metroplus $64 - $70 67%
UnitedHealthcare $64 - $220 67%
Elderplan $65 68%
Vns $65 68%
Wellcare Of Ny $66 69%
Humana $67 70%
Senior Whole Health $67 70%
Hamaspik Choice $73 77%
Magnacare $73 - $1,485 77%
Hotel Trades Council $90 - $1,912 95%
Emblemhealth $105 110%
United Behavioral Health $111 - $115 117%
World Trade Center Program $112 118%
Valueoptions $133 140%
Centers Plan For Healthy Living $200 210%
Empire Blue Priority $220 231%
Cigna $289 304%
Villagecaremax $313 329%
Oscar $438 460%
Centivo $456 479%
Create Health Plan $1,414 1485%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 89Th Avenue and Van Wyck Expressway, Jamaica, NY 11418
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals