Low-complexity outpatient consultation, unscheduled 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

HC OFFICE CONSULT LEVEL 3

Payers reporting CPT 99243

Payer pricing summary

Low

$44

Average

$214

Median

$206

High

$498

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Cigna fee schedule · outpatient · +30 other terms	85	$128	$256	$202	79%	2–20	$5 – $699
2	Humana fee schedule · outpatient · +23 other terms	160	$162	$256	$708	277%	1–10	$13 – $8.3k
3	Blue Cross Blue Shield fee schedule · outpatient · +32 other terms	172	$278	$291	$163	56%	—	$0 – $1.2k
4	UnitedHealthcare fee schedule · outpatient · +36 other terms	164	$112	$183	$172	94%	—	$1 – $2.7k
5	Aetna fee schedule · outpatient · +30 other terms	143	$113	$362	$960	265%	—	$9 – $8.4k
6	Anthem fee schedule · outpatient · +21 other terms	68	$106	$117	$80	68%	—	$13 – $771
7	Kaiser fee schedule · outpatient · +18 other terms	35	$113	$143	$85	59%	—	$5 – $478
8	Molina facility · case rate · outpatient · +21 other terms	35	$62	$79	$52	66%	—	$28 – $222
9	WellCare facility · fee schedule · outpatient · +15 other terms	31	$58	$79	$26	33%	—	$55 – $117
10	Caresource facility · case rate · outpatient · +12 other terms	26	$63	$52	$60	115%	—	$5 – $217
11	Medicaid fee schedule · outpatient · +8 other terms	26	$192	$181	$111	61%	—	$1 – $493
12	Devoted fee schedule · outpatient · +11 other terms	22	$112	$112	$1	1%	—	$109 – $113
13	Optum professional · fee schedule · outpatient · +15 other terms	21	$111	$86	$30	35%	—	$45 – $117
14	Bcbs Tx fee schedule · outpatient · +3 other terms	20	$408	$381	$130	34%	—	$114 – $654
15	Medica fee schedule · outpatient · +19 other terms	19	$219	$242	$97	40%	—	$62 – $393
16	Tricare facility · fee schedule · outpatient · +17 other terms	19	$55	$1.5k	$8.4k	544%	—	$37 – $50k
17	Medicare fee schedule · outpatient · +8 other terms	18	$113	$113	—	—	—	$113 – $113
18	Aetna Better Health fee schedule · outpatient · +10 other terms	17	$97	$105	$33	31%	—	$85 – $236
19	Highmark fee schedule · outpatient · +12 other terms	15	$103	$111	$42	38%	—	$87 – $408
20	MultiPlan fee schedule · outpatient · +18 other terms	15	$303	$311	$108	35%	—	$100 – $595
21	Amerihealth Caritas fee schedule · both · +5 other terms	14	$93	$93	$12	12%	—	$77 – $129
22	Regence fee schedule · outpatient · +6 other terms	14	$134	$144	$36	25%	—	$105 – $333
23	Ucare professional · fee schedule · outpatient · +12 other terms	14	$118	$113	$10	9%	—	$86 – $123
24	Bcbs Nj fee schedule · outpatient · +1 other terms	13	$65	$73	$30	41%	—	$65 – $177
25	Wellmark fee schedule · both · +12 other terms	13	$125	$125	—	—	—	$125 – $125

Page 1 of 3 · 58 payers