CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Maimonides Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $102
  • Cash Discount Price: $468
  • vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Maimonides Medical Center is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $468. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.87x the Medicare baseline. Located in 4802 Tenth Avenue, Brooklyn, NY.
Cash / Self-Pay
$468

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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%)
Cash / Self-Pay: $468 (398%)
Insurance Median: $102 (87%)
Cash: $468 (398% of Medicare)
Ins. Median: $102 (87% 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
Fidelis $12 - $169 10%
Healthfirst $12 - $259 10%
Metroplus $12 - $227 10%
Aetna $15 - $314 13%
Cigna $15 - $281 13%
United Community Plan $16 - $164 14%
Wellcare $16 - $151 14%
UnitedHealthcare $17 - $446 14%
Blue Cross Blue Shield $19 - $322 16%
Emblem Health - Hip $19 - $298 16%
Oxford Health Plan $21 - $212 18%
Magnacare $26 - $186 22%
Elderplan $29 - $204 25%
Emblem Health - Ghi $30 - $339 26%
Oxford Liberty $33 - $162 28%
Emblem Health - Hip Vip $50 - $143 43%
Visiting Nurse Svc Of Ny $52 - $162 44%
Molina $63 - $337 54%
Healthfirst Early Start $64 - $147 54%
Local 1199 $66 - $182 56%
Centers Plan For Healthy Living $68 - $191 58%
Hamaspik $79 - $224 67%
Villagecare Maxx Fida $89 - $134 76%
Elderserve Health $106 - $345 90%
Carelon Behavioral Health $128 109%
Centivo $130 - $310 111%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4802 Tenth Avenue, Brooklyn, NY 11219
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals