CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: St Francis Hospital - the Heart Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $155
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at St Francis Hospital - the Heart Center is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.32x the Medicare baseline. Located in 100 Port Washington Boulevard, Roslyn, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$155

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Insurance Median: $155 (132%)
Ins. Median: $155 (132% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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
UnitedHealthcare $54 - $298 46%
Health First $62 53%
Health Plus $65 55%
Us Family Health Plan $71 60%
Centers Plan For Healthy Living $93 79%
Surest $93 79%
Emblem Health $124 - $140 105%
Liberty Health $124 105%
Oscar Health $127 108%
American Plan Administrators $140 119%
Amerihealth Administrators $140 119%
Benefit Services $140 119%
Ghi Cbp Ny City Employee Alternate $140 119%
International Benefit Administrator $140 119%
Ultra Benefits Inc. $140 119%
Zadroga $141 120%
Aetna $155 132%
Apwu $155 132%
Brighton $155 - $217 132%
Centivo $155 132%
Cigna $155 - $217 132%
Daniel H Cook $155 132%
Local 1199 $155 132%
Mail Handlers Benefit Plan $155 132%
Meritain Health $155 132%
Mvp Health Plans $155 132%
Nalc $155 132%
Nippon Life Insurance Company Of America $155 132%
Salvation Army $155 132%
Samba $155 132%
Allied Wellfare Fund $217 185%
American Group Administrators $217 185%
Bakery & Confectionery Union $217 185%
Comprehensive Benefits Consultant $217 185%
Guardian Life Insurance Company Of America $217 185%
Maloney And Assoc $217 185%
Multiplan $217 185%
Performax $217 185%
Phcs $217 185%
Pomco $217 185%
Tpa Inc $217 185%
Unicare $217 185%
United Employees Health Plan $217 185%
Blue Cross Blue Shield $227 - $298 193%
Coventry $229 - $257 195%
Longevity Health Plan $248 211%
Galaxy $279 237%
Three Rivers Provider Network $279 237%
Self Pay $298 253%
Aither Health $310 264%
Alpha Care $310 264%
Dentaquest $310 264%
Veterans Affairs $310 264%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Port Washington Boulevard, Roslyn, NY 11576
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals