CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Samaritan Hospital of Troy, New York

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$96
about 1.0× the $95 Medicare rate · typically $66–$179
modeled estimate · not a bill or quote
What this hospital charges insurers
$143
Above the fair price
about $47 over the fair price · 1.5× Medicare
Medicare pays $95 Fair price $96 This hospital $143 Cash price $231 Hospital's list price $231

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 $143

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 $96 (about 1.0× the $95 Medicare rate). Samaritan Hospital of Troy, New York charges insurers about $143, or about $231 in cash — above the fair price. Located in Troy, 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 $96. 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.

6 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 $46 - $231 48%
Blue Cross Blue Shieldmajor $53 - $295 56%
Aetnamajor $59 - $231 62%
Cignamajor $231 - $409 243%
Humanamajor $70 - $231 74%
Kaiser Permanentemajor $231 243%
Ambetter (Centene) $231 243%
AmeriHealth $231 243%
AvMed $231 243%
Bright Health $231 243%
CareSource $231 243%
Clover Health $231 243%
Dean Health Plan $231 243%
Fidelis Care $101 - $231 106%
Friday Health $231 243%
GEHA $143 - $231 150%
Geisinger $231 243%
Harvard Pilgrim $231 243%
Health Net $231 243%
HealthLink $231 243%
HealthPartners $231 - $409 243%
Independent Health $231 243%
MagnaCare $231 243%
Medica $231 243%
Medical Mutual $231 243%
Meridian $231 243%
Moda Health $231 243%
Molina $231 243%
MVP Health Care $103 - $231 108%
Oscar Health $231 243%
PacificSource $231 243%
Paramount $231 243%
Presbyterian $231 243%
Priority Health $231 - $409 243%
Providence Health Plan $231 243%
Sanford Health Plan $231 243%
Security Health Plan $231 243%
SelectHealth $231 243%
Sentara $231 243%
Tufts Health Plan $231 - $409 243%
UCare $231 243%
UniCare $175 - $231 184%
UPMC Health Plan $231 243%
WellCare $231 243%
WellMed $231 243%
WellSense $231 243%
+ 1048 smaller / regional plans $45 - $409
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 42 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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.

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Facility Profile & Credentials

  • Address: 2215 Burdett Avenue, Troy, NY 12180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals