RC 515

Pediatric clinic 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

HC OFFICE OUTPATIENT NEW 30-44 MINUTES

Payers reporting RC 515

Payer pricing summary

Low

Average

$192

Median

$117

High

$1.2k

Payer rate distribution

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#
1	Molina per diem · both · +9 other terms	12	$118	$112	$23	20%	689–734	$68 – $161
2	Humana per diem · both · +10 other terms	12	$112	$113	$23	20%	78–132	$70 – $167
3	Anthem fee schedule · outpatient · +11 other terms	18	$139	$134	$28	21%	—	$36 – $159
4	Medcost percent of total billed charges · bothfrom % of charges	13	$27	$27	$16	61%	—	$7 – $51
5	Tricare fee schedule · both · +3 other terms	13	$3	$4	$1	36%	—	$3 – $9
6	UnitedHealthcare other · outpatient · +17 other terms	12	$206	$383	$610	159%	—	$150 – $3.3k
7	Cigna other · outpatient · +9 other terms	10	$164	$394	$1.2k	292%	—	$130 – $7.3k
8	Clover facility · percent of total billed charges · outpatientfrom % of charges	10	$81	$83	$48	58%	—	$17 – $149
9	Superior Healthplan case rate · both · +3 other terms	10	$75	$75	—	—	—	$75 – $75
10	Caresource per diem · both · +4 other terms	8	$104	$104	$24	23%	—	$66 – $156
11	Phcs percent of total billed charges · outpatientfrom % of charges · +1 other terms	8	$124	$135	$260	192%	—	$56 – $6.8k
12	Oscar percent of total billed charges · outpatientfrom % of charges	7	$81	$83	$76	92%	—	$45 – $792
13	Blue Cross Blue Shield fee schedule · outpatient · +11 other terms	4	$146	$142	$91	64%	—	$10 – $342
14	Aetna fee schedule · outpatient · +9 other terms	2	$86	$86	$45	52%	—	$19 – $136
15	Carefirst case rate · outpatient · +1 other terms	2	$121	$121	—	—	—	$121 – $121
16	Excellus fee schedule · outpatient · +3 other terms	2	$108	$111	$112	100%	—	$7 – $342
17	Medicare other · outpatient · +2 other terms	2	$2.5k	$2.5k	$648	26%	—	$1.9k – $3.2k
18	WellCare other · outpatient · +4 other terms	2	$2.6k	$2.6k	$667	26%	—	$1.9k – $3.3k
19	Aetna Better Health fee schedule · outpatient · +3 other terms	1	$1	$1	—	—	—	$1 – $1
20	Ambetter other · outpatient · +2 other terms	1	$4.9k	$4.9k	—	—	—	$4.9k – $4.9k
21	Amerihealth Caritas fee schedule · both · +1 other terms	1	$37	$37	$3	8%	—	$34 – $40
22	Bcbs La facility · fee schedule · both	1	$0	$0	—	—	—	$0 – $0
23	Devoted other · outpatient · +2 other terms	1	$2.7k	$2.7k	$680	26%	—	$2.0k – $3.3k
24	First Health facility · case rate · outpatient · +4 other terms	1	$74	$74	$19	25%	—	$51 – $97
25	Highmark fee schedule · both · +1 other terms	1	$98	$98	$71	73%	—	$34 – $214

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