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Initial hospital care, low complexity

CPT 99221 · negotiated-rate distribution across hospitals in NY

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Hospitals
8
Min
$77.66
Median
$85.61
Max
$370.8
Range multiplier
4.8×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield549$28.49$87.81$257.749.0×
UnitedHealthcare632$57.76$126.4$502.618.7×
Aetna624$65.46$114.5$606.389.3×
fidelis care416$65.46$78.94$104.731.6×
Medicaid115$25.47$69.31$83.983.3×
mvp314$77.01$89$197.562.6×
Healthfirst112$74.35$92.94$269.533.6×
Medicare112$58.25$77.34$102.891.8×
capital district physicians' health plan312$56.22$77.01$125.362.2×
Emblem Health111$35.25$42.3$372.3210.6×
Empire BCBS210$48.41$393.34$491.6810.2×
community care behavorial health university of pittsburgh medical center18$65$66.88$68.751.1×
Cigna48$120.56$245.81$5524.6×
[magnacare]16$370.8$430.2$4961.3×
community care behavorial health healthchoices16$65$66.88$68.751.1×
Multiplan36$230.85$490.5$5582.4×
Humana55$65.46$73.16$104.561.6×
beacon health15$56.54$116.82$137.442.4×
magnacare45$194.4$211.2$4962.6×
univera15$67.3$79.18$95.011.4×
mvp 290014$87.34$116.17$157.631.8×
oxford24$122.8$270.95$502.614.1×
choicecare24$80.73$85.95$104.951.3×
amerihealth14$68.3$81.31$94.321.4×
[fidelis]13$92.94$92.94$92.941.0×
[urn]13$401.7$448.5$483.61.2×
fidelis13$90.15$90.15$90.151.0×
martins point33$77.01$77.01$77.011.0×
Molina13$35.25$35.25$78.442.2×
VA Health33$77.01$77.01$77.011.0×
harvard pilgrim22$194.4$202.8$211.21.1×
excellus 220112$65.46$71.24$77.011.2×
independent health 515612$100.56$109.44$118.311.2×
valueoptions12$55$57.5$601.1×
Anthem BCBS12$78.44$78.44$78.441.0×
affinity12$48.41$48.41$48.411.0×
st. regis22$194.4$194.4$194.41.0×
[oxford]12$423.56$460.6$497.631.2×
[metroplus]12$162.65$240.25$317.852.0×
First Health22$218.7$221.55$224.41.0×
geisinger12$94.32$94.32$94.321.0×
fidelis 515512$91.06$98.98$106.891.2×
wellpath22$107.81$107.81$107.811.0×
emblemhealth11$161.49$161.49$161.491.0×
martin's point11$250$250$2501.0×
urn11$483.6$483.6$483.61.0×
elderplan 131611$71.91$71.91$71.911.0×
centers plan for healthy living11$92.28$92.28$92.281.0×
metroplus11$90.15$90.15$90.151.0×
6 degrees health11$496$496$4961.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
WESTFIELD MEMORIAL HOSPITALWESTFIELDNY10$231$50.82$65$87.81$250
HELEN HAYES HOSPITALWEST HAVERSTRAWNY4$736$736$48.41$85.61$552
ELIZABETHTOWN COMMUNITY HOSPITALELIZABETHTOWNNY15$264$264$34.9$84.71$237.6
NASSAU UNIVERSITY MEDICAL CENTEREAST MEADOWNY8$312$218.4$35.25$84.12$245.46
ALICE HYDE MEDICAL CENTERMALONENY12$263$263$34.9$83.07$257.74
FREDRICK FERRIS THOMPSON HOSPITALCANANDAIGUANY13$197$117.47$25.47$77.66$203.44
MEMORIAL HOSPITAL FOR CANCER AND ALLNEW YORKNY18$620$620$35.25$370.8$606.38
CHAMPLAIN VALLEY PHYSICIANS HOSPITALPLATTSBURGHNY16$243$243$34.9$107.81$230.85

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.