CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Ellis Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$84
about 0.9× the $95 Medicare rate · typically $63–$190
modeled estimate · not a bill or quote
What this hospital charges insurers
$220
Well above the fair price
about $136 over the fair price · 2.3× Medicare
Medicare pays $95 Fair price $84 This hospital $220 Cash price $119 Hospital's list price $239

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $56 Priciest $220

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 $84 (about 0.9× the $95 Medicare rate). Ellis Hospital charges insurers about $220, or about $119 in cash — well above the fair price. Located in Schenectady, NY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $84. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Aetna Blue Cross Blue ShieldCignaHumanaKaiser 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 $105 - $574 110%
Aetnamajor $109 - $610 115%
CDPHP $100 105%
MVP Health Care $220 231%
+ 4 smaller / regional plans $102 - $646
Government programs also on file: Military & VA.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 1101 Nott Street, Schenectady, NY 12308
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals