CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Glens Falls Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $121
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Glens Falls Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.89x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.
Cash / Self-Pay
$132

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $132 (97%)
Insurance Median: $121 (89%)
Cash: $132 (97% of Medicare)
Ins. Median: $121 (89% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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
Medicaid / KanCare $29 - $112 21%
Cdphp $36 - $197 27%
Medicare (plans) $68 - $121 50%
UnitedHealthcare $68 - $169 50%
Mvp $70 - $181 52%
Aetna $77 - $161 57%
Emblem Health Ghi $77 - $121 57%
Tricare $77 - $121 57%
Blue Cross Blue Shield $91 - $203 67%
Fidelis $91 - $188 67%
Cigna $110 - $181 81%
Blue Shield Highmark $111 - $133 82%
Blue Shield $130 - $299 96%
Hamaspik $140 - $203 103%
Nascentia Health Options $140 - $203 103%
Magnacare $162 - $235 119%
Emblem $173 - $250 128%
Empire Plan Nyship $184 - $266 136%
Multiplan $184 - $266 136%
Mvp Commercial $391 - $422 288%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Park Street, Glens Falls, NY 12801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals