CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Maimonides Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $106
  • Cash Discount Price: $468
  • vs. Medicare Baseline: 0.78x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Maimonides Medical Center is $106. 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 $135.6, this hospital’s rate is 0.78x 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
$106

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: $468 (345%)
Insurance Median: $106 (78%)
Cash: $468 (345% of Medicare)
Ins. Median: $106 (78% 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
Aetna $14 - $398 10%
Emblem Health - Hip $14 - $312 10%
Fidelis $14 - $262 10%
Healthfirst $14 - $271 10%
Metroplus $14 - $259 10%
UnitedHealthcare $14 - $365 10%
Blue Cross Blue Shield $15 - $320 11%
Cigna $15 - $293 11%
Elderplan $18 - $291 13%
Emblem Health - Ghi $18 - $356 13%
United Community Plan $18 - $188 13%
Wellcare $18 - $226 13%
Carelon Behavioral Health $21 - $218 15%
Magnacare $22 - $216 16%
Oxford Health Plan $22 - $305 16%
Oxford Liberty $22 - $197 16%
Visiting Nurse Svc Of Ny $23 - $221 17%
Emblem Health - Hip Vip $26 - $206 19%
Centers Plan For Healthy Living $34 - $165 25%
Local 1199 $34 - $207 25%
Molina $34 - $253 25%
Villagecare Maxx Fida $34 - $286 25%
Elderserve Health $69 - $251 51%
Healthfirst Early Start $73 - $194 54%
Hamaspik $91 - $226 67%
Mvp Health $92 - $132 68%
Centivo $96 - $244 71%

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