Initial hospital stay evaluation, low complexity

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

1st Hospital IP/Obs Care Sf/Low Mdm 40 Minutes

Payers reporting CPT 99221

Payer pricing summary

Low

$69

Average

$198

Median

$161

High

$1.7k

Payer rate distribution

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#
1	Medica professional · fee schedule · outpatient · +17 other terms	50	$73	$79	$21	27%	94	$61 – $197
2	Optum professional · fee schedule · outpatient · +16 other terms	58	$73	$70	$12	18%	50	$48 – $124
3	Medicare professional · fee schedule · outpatient · +19 other terms	43	$73	$73	$3	5%	33–42	$68 – $80
4	UnitedHealthcare fee schedule · both · +33 other terms	166	$146	$152	$92	60%	32–320	$0 – $503
5	Humana fee schedule · outpatient · +28 other terms	146	$80	$357	$800	224%	15	$0 – $8.3k
6	Molina professional · fee schedule · outpatient · +24 other terms	73	$73	$74	$13	18%	3–30	$35 – $141
7	Anthem fee schedule · outpatient · +21 other terms	74	$98	$193	$198	103%	2–20	$0 – $989
8	WellCare professional · fee schedule · outpatient · +22 other terms	59	$74	$75	$9	11%	1–10	$35 – $102
9	Blue Cross Blue Shield fee schedule · outpatient · +30 other terms	189	$287	$278	$160	57%	—	$0 – $714
10	Aetna fee schedule · outpatient · +31 other terms	143	$81	$282	$982	348%	—	$15 – $8.4k
11	Cigna professional · fee schedule · outpatient · +27 other terms	80	$111	$133	$70	52%	—	$35 – $371
12	Regence professional · fee schedule · outpatient · +17 other terms	60	$102	$118	$49	41%	—	$68 – $258
13	Tricare professional · fee schedule · outpatient · +20 other terms	55	$77	$77	$4	5%	—	$65 – $86
14	Ucare professional · fee schedule · outpatient · +13 other terms	47	$67	$71	$19	27%	—	$35 – $123
15	Devoted professional · fee schedule · outpatient · +14 other terms	45	$76	$77	$6	8%	—	$68 – $89
16	Caresource professional · fee schedule · outpatient · +19 other terms	42	$67	$68	$15	22%	—	$35 – $128
17	Medicaid professional · fee schedule · outpatient · +12 other terms	40	$65	$62	$8	13%	—	$35 – $82
18	Amerihealth Caritas professional · fee schedule · outpatient · +9 other terms	39	$65	$72	$14	20%	—	$35 – $102
19	First Health professional · fee schedule · outpatient · +18 other terms	39	$65	$117	$85	73%	—	$35 – $342
20	Highmark professional · fee schedule · outpatient · +16 other terms	39	$92	$93	$31	34%	—	$35 – $202
21	Wellmark fee schedule · both · +18 other terms	38	$136	$126	$23	18%	—	$74 – $140
22	MultiPlan professional · fee schedule · outpatient · +17 other terms	37	$157	$145	$41	28%	—	$88 – $284
23	Oscar professional · fee schedule · outpatient · +15 other terms	37	$80	$88	$23	26%	—	$68 – $128
24	Clover professional · fee schedule · outpatient · +12 other terms	36	$73	$73	$5	6%	—	$68 – $84
25	Kaiser professional · fee schedule · outpatient · +20 other terms	36	$90	$90	$51	57%	—	$35 – $479

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