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Office visit, new patient, 45-59 min

CPT 99204 · negotiated-rate distribution across hospitals in NY

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Hospitals
11
Min
$132.25
Median
$164.80
Max
$596.46
Range multiplier
4.5×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare971$20.80$169.12$827.0239.8×
Blue Cross Blue Shield670$69.13$152.30$600.748.7×
Emblem Health444$144.83$245.93$746.785.2×
Aetna735$101.24$185.22$981.579.7×
mvp533$115.00$198.00$729.186.3×
Healthfirst227$144.83$198.00$729.185.0×
Empire BCBS327$144.83$324.08$795.905.5×
Medicaid126$40.88$118.19$169.324.1×
Medicare221$91.87$127.58$293.003.2×
capital district physicians' health plan319$115.06$157.62$500.574.4×
fidelis care419$106.32$131.33$170.111.6×
fidelis218$144.83$195.09$729.185.0×
Molina217$56.57$192.17$729.1812.9×
carelon114$62.44$113.90$165.362.6×
community care behavorial health university of pittsburgh medical center112$92.00$130.00$209.002.3×
Cigna411$153.44$518.00$823.175.4×
community care behavorial health healthchoices19$92.00$130.00$209.002.3×
vns18$144.83$181.85$324.082.2×
oxford38$167.19$182.60$908.005.4×
magnacare67$220.00$490.40$800.003.6×
Multiplan37$484.20$756.00$900.001.9×
Humana57$106.32$125.08$172.761.6×
univera16$112.08$122.97$149.361.3×
mvp 290016$111.17$152.54$506.004.6×
amerihealth16$94.89$131.04$149.111.6×
[magnacare]16$604.80$696.60$800.001.3×
choicecare26$137.59$169.86$386.252.8×
beacon health15$105.58$109.80$109.801.0×
VA Health34$125.08$125.08$164.801.3×
independent health 515614$163.35$199.15$242.481.5×
martins point34$157.62$157.62$164.801.0×
excellus 220114$106.32$129.53$157.621.5×
fidelis 515514$147.30$179.19$217.701.5×
geisinger14$131.04$137.82$144.591.1×
st. regis23$164.80$508.80$508.803.1×
[urn]13$655.20$729.30$780.001.2×
centers plan for healthy living23$149.04$152.50$198.001.3×
First Health23$457.30$571.50$572.401.3×
harvard pilgrim23$430.40$508.00$508.801.2×
[fidelis]13$190.02$190.02$190.021.0×
partners health plan12$198.00$198.00$198.001.0×
pennsylvania health and wellness12$119.29$127.43$135.561.1×
wellpath22$175.11$175.11$175.111.0×
1199seiu national benefit funds12$208.88$246.64$284.401.4×
Anthem BCBS12$126.68$126.68$126.681.0×
capital district physicians health plan (cdphp) 514912$326.84$367.49$408.141.2×
[oxford]12$696.94$757.89$818.831.2×
[metroplus]12$332.54$491.20$649.872.0×
affinity12$175.00$175.00$175.001.0×
capital district (cdphp)12$697.50$697.50$697.501.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Memorial Hospital For Cancer And AllNew YorkNY18$1,000.00$1,000.00$145.80$596.46$981.57
Helen Hayes HospitalWest HaverstrawNY9$930.00$930.00$90.95$245.93$697.50
St. Josephs Medical CenterYonkersNY15$1,559.00$198.00$144.83$200.82$908.00
Champlain Valley Physicians HospitalPlattsburghNY17$636.00$636.00$105.58$200.00$604.20
Alice Hyde Medical CenterMaloneNY12$613.00$613.00$106.32$164.80$600.74
Elizabethtown Community HospitalElizabethtownNY15$538.00$538.00$106.32$157.62$484.20
Nassau University Medical CenterEast MeadowNY11$736.00$515.20$56.57$154.50$474.00
Fredrick Ferris Thompson HospitalCanandaiguaNY13$250.00$149.08$40.88$134.64$518.00
Westfield Memorial HospitalWestfieldNY15$592.00$461.76$20.80$132.25$374.85
Nyu Langone HospitalsNew YorkNY0$1,569.75$298.25
Eastern Long Island HospitalGreenportNY0$1,569.75$298.25

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.