Routine preventive checkup visit for an established patient

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-sonnet-5-5
Provider: anthropic
API: message_batches
Reasoning effort: model default
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR E&M Preventive Medicine Periodic Comprehensive Established Pt 5-11 Yrs

Payers reporting CPT 99393

Payer pricing summary

Low

$44

Average

$3.2k

Median

$156

High

$60.9k

Payer rate distribution

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#
1	Ambetter fee schedule · both · +19 other terms	17	$102	$141	$28	20%	19	$73 – $186
2	Oscar professional · fee schedule · both · +14 other terms	5	$113	$114	$17	15%	17–26	$86 – $140
3	Carefirst professional · fee schedule · both · +10 other terms	10	$106	$104	$25	24%	3–30	$52 – $149
4	Blue Cross Blue Shield fee schedule · outpatient · +28 other terms	173	$229	$243	$131	54%	2–20	$0 – $712
5	Humana fee schedule · outpatient · +25 other terms	232	$99	$191	$633	331%	1–10	$23 – $8.3k
6	Cigna fee schedule · outpatient · +26 other terms	97	$110	$170	$118	70%	1–10	$0 – $472
7	Excellus professional · fee schedule · both · +15 other terms	13	$100	$106	$41	38%	1–10	$52 – $274
8	Bcbs Mo professional · other · both · +2 other terms	1	$140	$140	—	—	1–10	$140 – $140
9	UnitedHealthcare fee schedule · outpatient · +35 other terms	181	$102	$140	$85	60%	—	$1 – $583
10	Aetna fee schedule · outpatient · +31 other terms	140	$104	$340	$929	273%	—	$20 – $8.4k
11	Anthem fee schedule · outpatient · +26 other terms	67	$104	$106	$30	29%	—	$22 – $321
12	Molina fee schedule · outpatient · +23 other terms	45	$88	$105	$67	63%	—	$22 – $275
13	Kaiser fee schedule · outpatient · +19 other terms	38	$110	$143	$89	63%	—	$5 – $523
14	Tricare fee schedule · both · +18 other terms	34	$71	$81	$16	19%	—	$57 – $131
15	Caresource fee schedule · outpatient · +19 other terms	33	$60	$145	$47	33%	—	$23 – $189
16	Bcbs Tx fee schedule · outpatient · +2 other terms	29	$311	$279	$107	38%	—	$89 – $526
17	Devoted fee schedule · outpatient · +15 other terms	23	$104	$116	$43	38%	—	$101 – $319
18	Medica fee schedule · both · +18 other terms	23	$159	$199	$109	55%	—	$55 – $331
19	Optum professional · fee schedule · outpatient · +15 other terms	23	$108	$89	$28	32%	—	$36 – $114
20	MultiPlan fee schedule · outpatient · +19 other terms	22	$158	$193	$130	67%	—	$45 – $468
21	Regence fee schedule · outpatient · +13 other terms	22	$130	$133	$46	35%	—	$38 – $341
22	Wellmark fee schedule · both · +17 other terms	22	$124	$127	$10	8%	—	$124 – $174
23	Aetna Better Health fee schedule · outpatient · +16 other terms	21	$69	$119	$97	82%	—	$60 – $395
24	WellCare fee schedule · outpatient · +22 other terms	21	$88	$81	$20	25%	—	$32 – $116
25	Highmark facility · fee schedule · outpatient · +16 other terms	20	$55	$126	$113	89%	—	$23 – $331

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