Outpatient office visit, established patient

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

PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN

Payers reporting CPT 99213

70 payers file a negotiated rate for this code. Each is shown once, under the terms the most hospitals file it under; rates under different terms (billing class, payment method, setting) are never blended, so open a payer to see them all. Figures are hospital-level averages; the median is across hospitals.

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#
1	UnitedHealthcare fee schedule · outpatient · +45 other terms	310	$89.13	$1,555	$1.00 – $999,999
2	Blue Cross Blue Shield fee schedule · outpatient · +35 other terms	298	$140.89	$155.97	$0.01 – $1,655
3	Aetna fee schedule · outpatient · +40 other terms	253	$91.04	$186.02	$1.00 – $8,450
4	Humana fee schedule · outpatient · +34 other terms	226	$91.04	$146.98	$1.10 – $8,334
5	Cigna fee schedule · outpatient · +35 other terms	175	$106.95	$158.63	$0.07 – $1,655
6	Anthem fee schedule · outpatient · +36 other terms	117	$97.04	$121.51	$13.94 – $2,421
7	MultiPlan fee schedule · outpatient · +21 other terms	95	$286.50	$216.30	$16.00 – $2,222
8	Molina fee schedule · outpatient · +31 other terms	85	$59.86	$67.79	$1.00 – $272.25
9	Kaiser fee schedule · outpatient · +27 other terms	63	$91.04	$133.73	$24.00 – $1,574
10	WellCare fee schedule · both · +28 other terms	61	$60.93	$69.25	$40.36 – $152.87
11	Highmark facility · fee schedule · outpatient · +19 other terms	59	$49.41	$132.87	$4.80 – $833.56
12	Ambetter fee schedule · both · +23 other terms	55	$99.00	$121.25	$35.00 – $464.00
13	Healthcare Highways percent of total billed charges · outpatientfrom % of charges · +2 other terms	49	$213.83	$230.72	$27.64 – $947.40
14	Regence professional · fee schedule · outpatient · +21 other terms	48	$75.70	$120.96	$9.38 – $281.27
15	Tricare facility · fee schedule · outpatient · +23 other terms	48	$63.76	$887.23	$6.48 – $50,000
16	Aetna Better Health fee schedule · outpatient · +20 other terms	45	$47.82	$71.03	$34.43 – $467.16
17	Optum professional · fee schedule · outpatient · +26 other terms	45	$74.73	$70.49	$9.38 – $99.80
18	Amerihealth Caritas facility · fee schedule · outpatient · +17 other terms	43	$44.80	$122.76	$31.22 – $395.42
19	Healthpartners fee schedule · both · +16 other terms	43	$115.60	$130.36	$61.57 – $225.99
20	Medica fee schedule · both · +25 other terms	42	$139.78	$185.25	$47.60 – $288.10
21	Medicaid facility · fee schedule · outpatient · +18 other terms	41	$79.99	$97.10	$12.00 – $411.58
22	Wellmark fee schedule · both · +26 other terms	40	$93.20	$92.23	$59.61 – $152.67
23	Devoted facility · fee schedule · outpatient · +22 other terms	39	$56.98	$57.97	$7.03 – $90.97
24	First Health professional · fee schedule · both · +21 other terms	38	$79.07	$79.85	$3.18 – $193.67
25	Caresource fee schedule · outpatient · +24 other terms	37	$111.07	$154.12	$1.08 – $189.15

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