Initial nursing facility 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

NURSING FACILITY INITIAL LOW COMPLEXITY

Payers reporting CPT 99304

Payer pricing summary

Low

Average

$5.7k

Median

$115

High

$107.2k

Payer rate distribution

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#
1	Humana fee schedule · outpatient · +26 other terms	154	$111	$345	$780	226%	—	$17 – $8.3k
2	Aetna fee schedule · outpatient · +27 other terms	122	$79	$328	$1.1k	343%	—	$17 – $8.4k
3	UnitedHealthcare fee schedule · both · +26 other terms	118	$81	$98	$70	71%	—	$0 – $366
4	Blue Cross Blue Shield fee schedule · outpatient · +25 other terms	70	$142	$178	$135	76%	—	$0 – $535
5	Anthem fee schedule · outpatient · +20 other terms	67	$84	$198	$205	104%	—	$17 – $970
6	Cigna fee schedule · outpatient · +21 other terms	63	$104	$105	$31	30%	—	$59 – $233
7	WellCare fee schedule · both · +19 other terms	48	$81	$82	$14	18%	—	$49 – $170
8	Molina professional · fee schedule · outpatient · +21 other terms	44	$78	$73	$12	16%	—	$44 – $106
9	Kaiser fee schedule · outpatient · +16 other terms	34	$77	$81	$35	43%	—	$17 – $186
10	Optum professional · fee schedule · outpatient · +14 other terms	27	$75	$73	$13	18%	—	$42 – $125
11	Regence professional · fee schedule · outpatient · +10 other terms	26	$78	$89	$22	25%	—	$64 – $198
12	Ambetter fee schedule · both · +13 other terms	24	$145	$151	$28	19%	—	$35 – $171
13	Devoted fee schedule · outpatient · +7 other terms	22	$79	$78	$1	1%	—	$76 – $79
14	Medica professional · fee schedule · outpatient · +15 other terms	21	$81	$85	$23	27%	—	$54 – $177
15	Caresource facility · case rate · outpatient · +11 other terms	20	$69	$84	$34	40%	—	$42 – $158
16	Medicare fee schedule · outpatient · +11 other terms	18	$77	$76	$2	2%	—	$72 – $79
17	Ucare professional · fee schedule · outpatient · +9 other terms	18	$71	$72	$16	22%	—	$56 – $122
18	Wellmark fee schedule · both · +11 other terms	17	$104	$105	$17	16%	—	$75 – $117
19	Highmark fee schedule · outpatient · +13 other terms	16	$85	$86	$30	35%	—	$29 – $302
20	Tricare professional · fee schedule · outpatient · +17 other terms	16	$73	$73	$6	8%	—	$62 – $84
21	Medicaid fee schedule · outpatient · +8 other terms	15	$46	$47	$10	21%	—	$38 – $70
22	Amerihealth Caritas fee schedule · both · +6 other terms	14	$81	$79	$11	14%	—	$41 – $96
23	MultiPlan professional · fee schedule · both · +16 other terms	14	$149	$148	$38	26%	—	$86 – $255
24	Aetna Better Health professional · fee schedule · both · +9 other terms	13	$56	$66	$17	26%	—	$49 – $97
25	Bcbs Nj fee schedule · outpatient · +1 other terms	13	$55	$62	$25	41%	—	$55 – $150

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