CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Nassau University Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $153
  • Cash Discount Price: $242
  • vs. Medicare Baseline: 1.61x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Nassau University Medical Center is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $242. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.61x the Medicare baseline. Located in 2201 Hempstead Turnpike, East Meadow, NY.
Cash / Self-Pay
$242

Average discount available for prompt cash payment at this facility.

Insurance Median
$153

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: $242 (254%)
Insurance Median: $153 (161%)
Cash: $242 (254% of Medicare)
Ins. Median: $153 (161% 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
Molina Healthcare (Fka Affinity) $22 - $62 23%
Aetna $44 - $194 46%
Emblemhealth $57 - $145 60%
Blue Cross Blue Shield $62 - $474 65%
Valueoptions $65 68%
Centers Plan For Healthy Living $73 - $152 77%
Fidelis Care $73 - $160 77%
1199Seiu National Benefit Funds $76 - $284 80%
Humana $76 - $152 80%
Cigna $87 - $3,498 91%
UnitedHealthcare $152 - $200 160%
Magnacare $169 - $261 178%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2201 Hempstead Turnpike, East Meadow, NY 11554
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals