Extended outpatient visit time, first hour

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

CARES PROLONGED E/M - 1ST HR

Payers reporting CPT 99354

Payer pricing summary

Low

$27

Average

$10.1k

Median

$224

High

$154.4k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Humana fee schedule · outpatient · +12 other terms	48	$79	$378	$1.2k	324%	—	$6 – $8.3k
2	UnitedHealthcare fee schedule · both · +21 other terms	34	$71	$83	$57	70%	—	$15 – $294
3	Anthem fee schedule · both · +11 other terms	26	$70	$86	$41	48%	—	$70 – $243
4	Baylor Scott White Health Plan facility · percent of total billed charges · outpatientfrom % of charges	26	$160	$130	$35	27%	—	$37 – $173
5	Blue Cross Blue Shield fee schedule · outpatient · +19 other terms	26	$344	$400	$218	54%	—	$0 – $681
6	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges	25	$45	$48	$16	32%	—	$24 – $92
7	Caresource facility · case rate · outpatient · +4 other terms	15	$59	$63	$14	23%	—	$39 – $100
8	Molina facility · case rate · outpatient · +8 other terms	15	$58	$63	$15	23%	—	$40 – $98
9	Wellmark fee schedule · both · +2 other terms	13	$195	$195	—	—	—	$195 – $195
10	Amerihealth Caritas fee schedule · both · +2 other terms	12	$79	$79	—	—	—	$79 – $79
11	Cigna fee schedule · both · +18 other terms	12	$144	$234	$144	62%	—	$124 – $556
12	WellCare fee schedule · both · +3 other terms	12	$79	$78	$0	0%	—	$78 – $79
13	Optum facility · case rate · outpatient · +4 other terms	11	$54	$60	$13	22%	—	$49 – $89
14	Aetna facility · fee schedule · outpatient · +19 other terms	10	$120	$931	$3.3k	350%	—	$14 – $13.9k
15	Bcbs Nj facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms	8	$25	$26	$5	21%	—	$20 – $51
16	Bcbs Pa facility · percent of total billed charges · outpatientfrom % of charges	8	$40	$42	$24	58%	—	$14 – $122
17	Devoted facility · fee schedule · outpatient · +3 other terms	8	$79	$77	$32	42%	—	$21 – $158
18	Bcbs Mn fee schedule · outpatient · +1 other terms	7	$190	$192	$64	33%	—	$99 – $237
19	First Health fee schedule · both · +9 other terms	6	$108	$140	$64	46%	—	$108 – $294
20	Ambetter fee schedule · both · +9 other terms	5	$169	$171	$18	11%	—	$145 – $294
21	Phcs fee schedule · both · +5 other terms	4	$233	$233	—	—	—	$233 – $233
22	Tricare facility · fee schedule · outpatient · +8 other terms	4	$196	$192	$154	80%	—	$13 – $422
23	Bcbs Tx facility · fee schedule · outpatient · +1 other terms	3	$428	$428	$10	2%	—	$414 – $435
24	Medcost professional · fee schedule · inpatient · +2 other terms	3	$195	$195	—	—	—	$195 – $195
25	Medical Mutual facility · percent of total billed charges · outpatientfrom % of charges · +3 other terms	3	$264	$5.0k	$11.7k	235%	—	$95 – $33.5k

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