CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Glens Falls Hospital

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$77

about 0.8× the $95 Medicare rate · typically $64–$169

modeled estimate · not a bill or quote

What this hospital charges insurers

$81

About the fair price

about $4 over the fair price · 0.9× Medicare

Medicare pays $95 Fair price $77 This hospital $81 Cash price $144 Hospital's list price $287

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 $81

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 $77 (about 0.8× the $95 Medicare rate). Glens Falls Hospital charges insurers about $81, or about $144 in cash — about the fair price. Located in Glens Falls, NY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser 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 - $120	48%
Blue Cross Blue Shieldmajor	$58 - $341	61%
Aetnamajor	$50 - $114	53%
Cignamajor	$71 - $125	75%
CDPHP	$24 - $140	25%
Fidelis Care	$62 - $315	65%
MagnaCare	$162 - $394	170%
MVP Health Care	$46 - $422	48%
+ 5 smaller / regional plans	$53 - $446

Government programs also on file: Medicare, Medicaid, Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 144), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 99213.

Insurance Before you use insurance

Call your insurance company to confirm Glens Falls Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 99213.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Glens Falls Hospital

Compare: Office visit, established patient (20-29 min) at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.