CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mercy Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $155
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercy Medical Center is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.32x the Medicare baseline. Located in 1000 North Village Avenue, Rockville Centre, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$155

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%)
Insurance Median: $155 (132%)
Ins. Median: $155 (132% 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
UnitedHealthcare $43 - $298 37%
Health First $62 53%
Health Plus $65 55%
Us Family Health Plan $71 60%
Fidelis Care New York $73 62%
Centers Plan For Healthy Living $93 79%
Surest $93 79%
Beacon Health Strategies $124 105%
Emblem Health $124 - $155 105%
Liberty Health $124 105%
Oscar Health $127 108%
Magellan $135 115%
American Plan Administrators $140 119%
Amerihealth Administrators $140 119%
Benefit Services $140 119%
Ghi Cbp Ny City Employee Alternate $140 119%
International Benefit Administrator $140 119%
Ultra Benefits Inc. $140 119%
Zadroga $141 120%
Aetna $155 132%
Apwu $155 132%
Beacon Health Options $155 132%
Blue Cross Blue Shield $155 - $298 132%
Centivo $155 132%
Cigna $155 - $202 132%
Daniel H Cook $155 132%
Local 1199 $155 132%
Mail Handlers Benefit Plan $155 132%
Meritain Health $155 132%
Mvp Health Plans $155 132%
Nalc $155 132%
Nippon Life Insurance Company Of America $155 132%
Salvation Army $155 132%
Samba $155 132%
Allied Wellfare Fund $202 172%
American Group Administrators $202 172%
Bakery & Confectionery Union $202 172%
Brighton $202 - $285 172%
Comprehensive Benefits Consultant $202 172%
Guardian Life Insurance Company Of America $202 172%
Maloney And Assoc $202 172%
Multiplan $202 172%
Performax $202 172%
Phcs $202 172%
Pomco $202 172%
Tpa Inc $202 172%
Unicare $202 172%
United Employees Health Plan $202 172%
Coventry $229 - $248 195%
Longevity Health Plan $248 211%
Galaxy $279 237%
Three Rivers Provider Network $279 237%
Self Pay $298 253%
Aither Health $310 264%
Alpha Care $310 264%
Dentaquest $310 264%
Veterans Affairs $310 264%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 North Village Avenue, Rockville Centre, NY 11571
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals