Initial high-complexity hospital inpatient or observation visit

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 Hospital IP/Obs Care Initial High Level per Day

Payers reporting CPT 99223

Payer pricing summary

Low

$107

Average

$330

Median

$288

High

$1.7k

Payer rate distribution

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#
1	Ucare professional · fee schedule · outpatient · +13 other terms	48	$143	$148	$40	27%	279–297	$71 – $264
2	UnitedHealthcare fee schedule · both · +30 other terms	168	$292	$324	$181	56%	258–276	$0 – $1.0k
3	Optum professional · fee schedule · outpatient · +19 other terms	59	$152	$153	$35	23%	254–290	$94 – $354
4	Medicare professional · fee schedule · outpatient · +19 other terms	44	$153	$153	$6	4%	231–258	$145 – $168
5	Medica professional · fee schedule · outpatient · +17 other terms	52	$152	$163	$41	25%	176–212	$130 – $393
6	Anthem fee schedule · outpatient · +21 other terms	73	$206	$405	$416	103%	84	$0 – $2.1k
7	Aetna fee schedule · outpatient · +30 other terms	151	$169	$375	$923	246%	62–125	$20 – $8.4k
8	Molina professional · fee schedule · outpatient · +23 other terms	75	$155	$156	$28	18%	45–81	$71 – $299
9	Humana fee schedule · outpatient · +26 other terms	152	$167	$615	$937	152%	36–54	$0 – $8.3k
10	Kaiser fee schedule · outpatient · +20 other terms	37	$169	$185	$80	43%	16	$80 – $523
11	Cigna professional · fee schedule · outpatient · +25 other terms	80	$233	$253	$113	45%	14	$71 – $733
12	Blue Cross Blue Shield fee schedule · outpatient · +29 other terms	188	$572	$550	$320	58%	8–80	$0 – $1.4k
13	Highmark professional · fee schedule · outpatient · +16 other terms	39	$195	$192	$64	33%	2–20	$71 – $402
14	WellCare professional · fee schedule · outpatient · +21 other terms	60	$155	$156	$17	11%	1–10	$71 – $202
15	Tricare professional · fee schedule · outpatient · +20 other terms	55	$162	$162	$8	5%	1–10	$138 – $180
16	Wellmark fee schedule · both · +18 other terms	39	$285	$265	$48	18%	1–10	$156 – $293
17	Oscar professional · fee schedule · outpatient · +15 other terms	37	$160	$185	$49	27%	1–10	$145 – $272
18	Bcbs Mo professional · other · both	1	$293	$293	—	—	1–10	$293 – $293
19	Regence professional · fee schedule · outpatient · +15 other terms	61	$209	$246	$101	41%	—	$145 – $538
20	Devoted professional · fee schedule · outpatient · +13 other terms	46	$158	$161	$13	8%	—	$145 – $188
21	Caresource professional · fee schedule · outpatient · +18 other terms	43	$144	$146	$31	21%	—	$71 – $269
22	Amerihealth Caritas professional · fee schedule · outpatient · +10 other terms	40	$143	$149	$28	19%	—	$71 – $207
23	Medicaid professional · fee schedule · outpatient · +11 other terms	40	$136	$131	$20	15%	—	$71 – $164
24	First Health professional · fee schedule · outpatient · +19 other terms	39	$144	$200	$117	59%	—	$71 – $585
25	MultiPlan professional · fee schedule · outpatient · +19 other terms	38	$332	$304	$85	28%	—	$185 – $567

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