Periodic assessment 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

Periodic assessment

Payers reporting HCPCS G2077

Payer pricing summary

Low

Average

$184

Median

$177

High

$508

Payer rate distribution

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#
1	Blue Cross Blue Shield facility · fee schedule · outpatient · +9 other terms	33	$357	$294	$212	72%	—	$11 – $886
2	Molina facility · case rate · outpatient · +5 other terms	29	$187	$196	$45	23%	—	$110 – $342
3	Aetna fee schedule · outpatient · +8 other terms	23	$119	$237	$204	86%	—	$106 – $1.1k
4	UnitedHealthcare facility · case rate · outpatient · +6 other terms	18	$180	$194	$45	23%	—	$110 – $309
5	Humana fee schedule · outpatient · +6 other terms	16	$340	$295	$131	45%	—	$115 – $462
6	Anthem facility · case rate · outpatient · +7 other terms	15	$179	$194	$48	24%	—	$107 – $303
7	Caresource facility · case rate · outpatient · +1 other terms	15	$182	$195	$47	24%	—	$107 – $309
8	Highmark fee schedule · outpatient · +3 other terms	13	$117	$122	$42	34%	—	$109 – $539
9	Optum facility · case rate · outpatient · +1 other terms	13	$162	$180	$40	22%	—	$149 – $274
10	Bcbs Nj fee schedule · outpatient	12	$44	$44	—	—	—	$44 – $44
11	Cigna professional · fee schedule · outpatient · +4 other terms	9	$50	$50	—	—	—	$50 – $50
12	Bcbs Mn fee schedule · both · +2 other terms	8	$111	$111	$1	1%	—	$110 – $112
13	Aetna Better Health fee schedule · inpatient · +2 other terms	7	$119	$119	—	—	—	$119 – $119
14	Amerihealth Caritas facility · case rate · outpatient · +2 other terms	7	$173	$175	$6	3%	—	$173 – $189
15	First Health professional · fee schedule · both · +4 other terms	3	$117	$117	—	—	—	$117 – $117
16	Medicaid fee schedule · outpatient · +2 other terms	3	$204	$204	—	—	—	$204 – $204
17	WellCare fee schedule · both · +3 other terms	3	$136	$134	$2	2%	—	$131 – $136
18	Wellmark facility · case rate · outpatient	3	$579	$508	$160	32%	—	$236 – $639
19	MultiPlan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	2	$204	$204	—	—	—	$204 – $204
20	Ambetter fee schedule · both · +1 other terms	1	$124	$124	—	—	—	$124 – $124
21	Bcbs La facility · fee schedule · outpatient	1	$0	$0	—	—	—	$0 – $0
22	Bcbs Nv fee schedule · outpatient	1	$114	$114	—	—	—	$114 – $114
23	Bcbs Vt professional · fee schedule · outpatient	1	$112	$112	—	—	—	$112 – $112
24	Excellus facility · fee schedule · outpatient	1	$110	$110	—	—	—	$110 – $110
25	Healthpartners facility · fee schedule · outpatient	1	$431	$431	—	—	—	$431 – $431

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