CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Saratoga Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $102
  • Cash Discount Price: $172
  • vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Saratoga Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.87x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.
Cash / Self-Pay
$172

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: $172 (146%)
Insurance Median: $102 (87%)
Cash: $172 (146% 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
Medicaid / KanCare $29 - $100 25%
Cdphp $30 - $171 26%
Fidelis $58 - $110 49%
Medicare (plans) $58 - $105 49%
Blue Cross Blue Shield $63 - $129 54%
Tricare $65 - $105 55%
Mvp $67 - $179 57%
Hamaspik $72 - $131 61%
UnitedHealthcare $72 - $501 61%
Aetna $75 - $120 64%
Emblem Health Ghi $77 - $115 65%
Mvp Commercial $84 - $418 71%
Multiplan $90 - $473 77%
Emblem $96 - $446 82%
Empire Plan Nyship $102 - $473 87%
Cigna $105 - $179 89%
Magnacare $108 - $529 92%
Blue Shield Highmark $109 - $135 93%
Nascentia Health Options $113 96%
Blue Shield $120 - $374 102%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 211 Church Street, Saratoga Springs, NY 12866
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals