CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Ellenville Regional Hospital

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $155
  • Cash Discount Price: $207
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Ellenville Regional Hospital is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $207. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.32x the Medicare baseline. Located in 10 Healthy Way, Ellenville, NY.
Cash / Self-Pay
$207

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%)
Cash / Self-Pay: $207 (176%)
Insurance Median: $155 (132%)
Cash: $207 (176% of Medicare)
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 $41 - $161 35%
Emblemhealth $94 - $221 80%
Cdphp $102 87%
Blue Cross Blue Shield $110 94%
Fidelis $110 94%
Hamaspik Choice $110 94%
Humana $110 94%
Mvp Health Care Of Ny $116 - $207 99%
Aetna $127 - $193 108%
Local 1199Seiu $127 - $193 108%
Wellcare $152 129%
Oxford Health Plans $161 137%
Galaxy Health $179 152%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Healthy Way, Ellenville, NY 12428
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals