CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Saratoga Hospital

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $110
  • Cash Discount Price: $220
  • vs. Medicare Baseline: 0.81x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Saratoga Hospital is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $220. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.81x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.
Cash / Self-Pay
$220

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $220 (162%)
Insurance Median: $110 (81%)
Cash: $220 (162% of Medicare)
Ins. Median: $110 (81% 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%
Fidelis $67 - $127 49%
Medicare (plans) $68 - $121 50%
Mvp $70 - $181 52%
Blue Cross Blue Shield $75 - $466 55%
UnitedHealthcare $76 - $599 56%
Aetna $77 - $137 57%
Tricare $77 - $121 57%
Mvp Commercial $84 - $500 62%
Hamaspik $85 - $151 63%
Multiplan $90 - $566 66%
Emblem Health Ghi $91 - $133 67%
Emblem $96 - $533 71%
Empire Plan Nyship $102 - $566 75%
Magnacare $108 - $633 80%
Cigna $110 - $181 81%
Blue Shield Highmark $111 - $135 82%
Blue Shield $120 - $376 88%
Nascentia Health Options $135 100%

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