CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: St James Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$68
about 0.7× the $95 Medicare rate · typically $56–$108
modeled estimate · not a bill or quote
What this hospital charges insurers
$65
About the fair price
about $3 under the fair price · 0.7× Medicare
Medicare pays $95 Fair price $68 This hospital $65 Cash price $98 Hospital's list price $146

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

A typical price — 3 charge more and 4 charge less, among the 9 NY hospitals compared.

Cheapest $56 Priciest $66

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

A fair price for a Office visit, established patient (20-29 min) is about $68 (about 0.7× the $95 Medicare rate). St James Hospital charges insurers about $65, or about $98 in cash — about the fair price. Located in Hornell, NY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $42 - $88 44%
Blue Cross Blue Shieldmajor $30 - $125 32%
Aetnamajor $42 - $88 44%
Cignamajor $61 - $126 64%
Humanamajor $56 59%
CDPHP $162 - $221 170%
Fidelis Care $48 - $78 50%
MVP Health Care $44 - $122 46%
+ 1 smaller / regional plan $56
Government programs also on file: Medicare, Medicaid.

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Facility Profile & Credentials

  • Address: 411 Canisteo Street, Hornell, NY 14843
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals