Developmental screening test with report

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Fee Schedule

Payers reporting CPT 96111

Payer pricing summary

Low

$43

Average

$613

Median

$343

High

$11.2k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +13 other terms	39	$58	$430	$1.5k	344%	—	$39 – $8.3k
2	Blue Cross Blue Shield fee schedule · outpatient · +15 other terms	29	$546	$565	$268	47%	—	$48 – $910
3	Anthem fee schedule · outpatient · +9 other terms	23	$98	$114	$55	48%	—	$50 – $368
4	UnitedHealthcare fee schedule · outpatient · +17 other terms	18	$117	$148	$140	95%	—	$36 – $712
5	MultiPlan fee schedule · outpatient · +8 other terms	13	$218	$188	$120	64%	—	$74 – $549
6	Wellmark fee schedule · both · +5 other terms	13	$231	$230	$22	10%	—	$215 – $262
7	Tricare fee schedule · outpatient · +4 other terms	12	$125	$114	$27	24%	—	$50 – $125
8	Highmark fee schedule · outpatient · +4 other terms	10	$144	$144	$4	3%	—	$131 – $145
9	Phcs fee schedule · inpatient · +8 other terms	10	$182	$153	$36	23%	—	$109 – $182
10	Medica fee schedule · outpatient · +2 other terms	9	$168	$131	$43	33%	—	$39 – $196
11	Cigna per diem · inpatient · +17 other terms	7	$76	$109	$66	60%	—	$73 – $263
12	Aetna case rate · inpatient · +14 other terms	6	$76	$81	$9	11%	—	$73 – $93
13	Molina fee schedule · outpatient · +7 other terms	6	$166	$154	$105	69%	—	$28 – $368
14	First Health fee schedule · both · +4 other terms	5	$157	$157	—	—	—	$157 – $157
15	Ambetter per diem · inpatient · +3 other terms	4	$74	$74	$1	2%	—	$73 – $76
16	Bcbs Mn fee schedule · outpatient	4	$44	$43	$29	67%	—	$13 – $105
17	Amerihealth Caritas fee schedule · outpatient · +1 other terms	3	$230	$134	$106	79%	—	$29 – $250
18	Caresource fee schedule · outpatient · +2 other terms	3	$103	$136	$120	89%	—	$50 – $406
19	Medcost professional · percent of total billed charges · inpatientfrom % of charges · +1 other terms	3	$432	$432	—	—	—	$432 – $432
20	Medicaid fee schedule · outpatient · +4 other terms	3	$163	$163	—	—	—	$163 – $163
21	Oscar facility · per diem · outpatient · +3 other terms	3	$443	$1.4k	$4.0k	278%	—	$400 – $17.5k
22	WellCare case rate · inpatient · +2 other terms	3	$75	$75	$1	1%	—	$74 – $76
23	Aetna Better Health fee schedule · inpatient · +2 other terms	2	$470	$470	—	—	—	$470 – $470
24	Bcbs Ca facility · per diem · outpatient · +3 other terms	2	$648	$580	$223	38%	—	$198 – $848
25	Bcbs Ok per diem · inpatient	2	$93	$93	—	—	—	$93 – $93

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