PR E&M Preventive Medicine Periodic Comprehensive Established Pt 18-39 Yrs

Excellus pricing summary

Low

$78

Average

$1.1k

Median

$117

High

$44k

Excellus rate distribution

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90 hospital rates

#		Plans
1	Samaritan Hospital Troy, NY professional · percent of total billed charges · bothfrom % of charges	1	$297	$297	—	—	123–132	$297 – $297
2	St Peters Hospital Albany, NY professional · percent of total billed charges · bothfrom % of charges	1	$297	$297	—	—	95	$297 – $297
3	Samaritan Medical Center Watertown, NY facility · other · inpatient	2	$129	$129	—	—	38	$129 – $129
4	Samaritan Medical Center Watertown, NY facility · other · outpatient	1	$129	$129	—	—	25	$129 – $129
5	Samaritan Medical Center Watertown, NY professional · other · both	1	$129	$129	—	—	25	$129 – $129
6	Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · outpatient	2	$106	$106	$50	47%	2–20	$56 – $156
7	Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both	2	$117	$117	$29	25%	1–10	$88 – $147
8	Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient	2	$110	$110	$6	5%	1–10	$104 – $116
9	Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient	1	$137	$137	—	—	1–10	$137 – $137
10	Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges	1	$186	$186	—	—	1–10	$186 – $186
11	St Josephs Hospital Health Center Syracuse, NY facility · percent of total billed charges · bothfrom % of charges	4	$343	$311	$64	21%	1–10	$183 – $343
12	St. Francis Hospital Inc Wilmington, DE professional · fee schedule · both	2	$87	$87	$6	6%	1–10	$81 – $92
13	Alice Hyde Medical Center Malone, NY professional · fee schedule · both	2	$111	$111	$14	13%	—	$97 – $125
14	CLIFTON-FINE HEALTHCARE CORPORATION STAR LAKE, NY fee schedule · outpatient	1	$258	$258	—	—	—	$258 – $258
15	Central Community Hospital Elkader, IA professional · fee schedule · inpatient	2	$117	$117	$29	25%	—	$88 – $147
16	Central Community Hospital Elkader, IA professional · fee schedule · outpatient	2	$145	$145	$57	39%	—	$88 – $202
17	Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY professional · fee schedule · both	2	$111	$111	$14	13%	—	$97 – $125
18	Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient	1	$136	$136	—	—	—	$136 – $136
19	Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both	2	$100	$100	$25	25%	—	$75 – $125
20	Elizabethtown Community Hospital Elizabethtown, NY professional · fee schedule · both	2	$111	$111	$14	13%	—	$97 – $125
21	F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient	3	$82	$80	$30	37%	—	$27 – $140
22	Highland Hospital Rochester, NY fee schedule · outpatient	4	$37	$105	$118	112%	—	$37 – $310
23	Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both	1	$763	$763	—	—	—	$763 – $763
24	Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · inpatient	2	$69	$69	$17	24%	—	$52 – $86
25	Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · outpatient	2	$82	$82	$16	20%	—	$65 – $98

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← Payers reporting CPT 99395 · Snapshot 20261111T120946Z-9134e7f7

CPT 99395

PR E&M Preventive Medicine Periodic Comprehensive Established Pt 18-39 Yrs

Excellus pricing summary

Low

$78

Average

$1.1k

Median

$117

High

$44k

Excellus rate distribution

Filter by billing methodology

Filter by billing class

90 hospital rates

#		Plans
1	Samaritan Hospital Troy, NY professional · percent of total billed charges · bothfrom % of charges	1	$297	$297	—	—	123–132	$297 – $297
2	St Peters Hospital Albany, NY professional · percent of total billed charges · bothfrom % of charges	1	$297	$297	—	—	95	$297 – $297
3	Samaritan Medical Center Watertown, NY facility · other · inpatient	2	$129	$129	—	—	38	$129 – $129
4	Samaritan Medical Center Watertown, NY facility · other · outpatient	1	$129	$129	—	—	25	$129 – $129
5	Samaritan Medical Center Watertown, NY professional · other · both	1	$129	$129	—	—	25	$129 – $129
6	Saint Francis Hospital and Medical Center Hartford, CT professional · fee schedule · outpatient	2	$106	$106	$50	47%	2–20	$56 – $156
7	Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · both	2	$117	$117	$29	25%	1–10	$88 – $147
8	Mercy Health Lakeshore Campus Shelby, MI professional · fee schedule · outpatient	2	$110	$110	$6	5%	1–10	$104 – $116
9	Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient	1	$137	$137	—	—	1–10	$137 – $137
10	Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges	1	$186	$186	—	—	1–10	$186 – $186
11	St Josephs Hospital Health Center Syracuse, NY facility · percent of total billed charges · bothfrom % of charges	4	$343	$311	$64	21%	1–10	$183 – $343
12	St. Francis Hospital Inc Wilmington, DE professional · fee schedule · both	2	$87	$87	$6	6%	1–10	$81 – $92
13	Alice Hyde Medical Center Malone, NY professional · fee schedule · both	2	$111	$111	$14	13%	—	$97 – $125
14	CLIFTON-FINE HEALTHCARE CORPORATION STAR LAKE, NY fee schedule · outpatient	1	$258	$258	—	—	—	$258 – $258
15	Central Community Hospital Elkader, IA professional · fee schedule · inpatient	2	$117	$117	$29	25%	—	$88 – $147
16	Central Community Hospital Elkader, IA professional · fee schedule · outpatient	2	$145	$145	$57	39%	—	$88 – $202
17	Champlain Valley Physicians Hospital Medical Center Plattsburgh, NY professional · fee schedule · both	2	$111	$111	$14	13%	—	$97 – $125
18	Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient	1	$136	$136	—	—	—	$136 – $136
19	Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both	2	$100	$100	$25	25%	—	$75 – $125
20	Elizabethtown Community Hospital Elizabethtown, NY professional · fee schedule · both	2	$111	$111	$14	13%	—	$97 – $125
21	F.F. Thompson Hospital Canandaigua, NY fee schedule · outpatient	3	$82	$80	$30	37%	—	$27 – $140
22	Highland Hospital Rochester, NY fee schedule · outpatient	4	$37	$105	$118	112%	—	$37 – $310
23	Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · per diem · both	1	$763	$763	—	—	—	$763 – $763
24	Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · inpatient	2	$69	$69	$17	24%	—	$52 – $86
25	Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL professional · fee schedule · outpatient	2	$82	$82	$16	20%	—	$65 – $98

Page 1 of 4

← Payers reporting CPT 99395 · Snapshot 20261111T120946Z-9134e7f7