CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: NYU Langone Hospitals

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $592
  • Cash Discount Price: $221
  • vs. Medicare Baseline: 5.04x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at NYU Langone Hospitals is $592. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $221. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 5.04x the Medicare baseline. Located in 550 First Avenue, New York, NY.
Cash / Self-Pay
$221

Average discount available for prompt cash payment at this facility.

Insurance Median
$592

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: $221 (188%)
Insurance Median: $592 (504%)
Cash: $221 (188% of Medicare)
Ins. Median: $592 (504% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 504% of the Medicare baseline (a markup of 404%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Healthfirst $83 - $90 71%
Healthplus $83 71%
Ghi $90 - $3,624 77%
Hip $90 - $2,758 77%
Medicare (plans) $90 - $92 77%
Wellcare $90 - $92 77%
Centerlight $92 - $94 78%
Hamaspik $135 - $138 115%
Oscar $221 188%
Aetna $236 - $1,570 201%
Oxford $285 - $786 242%
UnitedHealthcare $355 - $418 302%
Cigna $524 446%
Multiplan $592 - $1,224 504%
1199 $757 644%
Magnacare $860 - $1,387 731%
Blue Cross Blue Shield $928 - $1,160 789%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 550 First Avenue, New York, NY 10016
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals