CMS Price Transparency Data
Office visit, established patient (20-29 min)
Facility: Ellenville Regional Hospital
Billing Code: 99213 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$111
about 1.2× the $95 Medicare rate · typically $71–$245
modeled estimate · not a bill or quote
Medicare pays $95 Fair price $111 Cash price $111 Hospital's list price $148
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $22 - $161 | 23% |
| Blue Cross Blue Shieldmajor | $59 | 62% |
| Aetnamajor | $68 - $104 | 71% |
| Humanamajor | $59 | 62% |
| CDPHP | $55 | 58% |
| EmblemHealth | $50 - $118 | 53% |
| Fidelis Care | $59 | 62% |
| MVP Health Care | $62 - $111 | 65% |
| WellCare | $81 | 85% |
| + 3 smaller / regional plans | $59 - $161 |
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
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Other Procedures at Ellenville Regional Hospital
Compare: Office visit, established patient (20-29 min) at other NY hospitals
- Oswego Hospital · Oswego $56
- UPMC Chautauqua at Wca · Jamestown $59
- Westchester Medical Center · Valhalla $63
- St John's Episcopal Hospital at South Shore · Far Rockaway $64
- St James Hospital · Hornell $65
- St John's Riverside Hospital · Yonkers $65
- Wyckoff Heights Medical Center · Brooklyn $66
- Suny/Stony Brook University Hospital · Stony Brook $66
Insurance negotiated median for the same procedure, sorted lowest first.