CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Nassau University Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $153
Cash Discount Price: $332
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Nassau University Medical Center is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $332. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.13x the Medicare baseline. Located in 2201 Hempstead Turnpike, East Meadow, NY.

Cash / Self-Pay

$332

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

$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)

Cash / Self-Pay: $332 (245%)

Insurance Median: $153 (113%)

Cash: $332 (245% of Medicare)

Ins. Median: $153 (113% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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
Molina Healthcare (Fka Affinity)	$34 - $91	25%
Valueoptions	$47	35%
Aetna	$59 - $286	44%
Cigna	$87	64%
Blue Cross Blue Shield	$91 - $523	67%
Emblemhealth	$100 - $188	74%
Centers Plan For Healthy Living	$108 - $152	80%
Fidelis Care	$108 - $160	80%
Humana	$112 - $152	83%
1199Seiu National Benefit Funds	$133 - $314	98%
UnitedHealthcare	$152 - $200	112%
Magnacare	$220 - $261	162%

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 $332.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Nassau University Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99214.
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.