Outpatient office visit, established patient at Alice Hyde Medical Center

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

PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN

Malone, NY

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Pricing by billing methodology

Price type

How this price compares nationally

Alice Hyde Medical Center’s median price of $86 is 31% below the median hospital's median price ($124), higher than 26% of the 2,009 hospitals reporting CPT 99213. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99213 at Alice Hyde Medical Center

Negotiated rates from the hospital’s own file: 5 payers, 19 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Excellus managed medicaid/essential plans facility · percent of total billed charges · outpatientfrom % of charges	$66.92	$66.92	$66.92 – $66.92
2	Excellus managed medicaid/essential plans professional · fee schedule · both	$70.06	$70.06	$70.06 – $70.06
3	Humana tricare professional · fee schedule · both	$72.98	$72.98	$72.98 – $72.98
4	Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$78.87	$78.87	$78.87 – $78.87
5	Excellus medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$78.87	$78.87	$78.87 – $78.87
6	Humana tricare facility · percent of total billed charges · outpatientfrom % of charges	$78.87	$78.87	$78.87 – $78.87
7	UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$78.87	$78.87	$78.87 – $78.87
8	Excellus commercial professional · fee schedule · both	$92.11	$92.11	$92.11 – $92.11
9	Aetna medicare advantage professional · fee schedule · both	$92.32	$92.32	$92.32 – $92.32
10	Excellus medicare advantage professional · fee schedule · both	$92.32	$92.32	$92.32 – $92.32
11	Aetna commercial professional · fee schedule · both	$134.61	$134.61	$134.61 – $134.61
12	UnitedHealthcare managed medicaid/essential plans professional · percent of total billed charges · bothfrom % of charges	$137.55	$137.55	$137.55 – $137.55
13	UnitedHealthcare medicare advantage professional · percent of total billed charges · bothfrom % of charges	$137.55	$137.55	$137.55 – $137.55
14	UnitedHealthcare commercial ppo for ny state employees professional · fee schedule · both	$154.27	$154.27	$141.76 – $166.77
15	Excellus commercial facility · percent of total billed charges · outpatientfrom % of charges	$199.83	$199.83	$199.83 – $199.83
16	UnitedHealthcare commercial professional · fee schedule · both	$203.33	$203.33	$203.33 – $203.33
17	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$207.69	$207.69	$207.69 – $207.69
18	Highmark ind/fep/ppo/hmo facility · percent of total billed charges · outpatientfrom % of charges	$214.14	$214.14	$214.14 – $214.14
19	Highmark ind/fep/ppo/hmo professional · percent of total billed charges · bothfrom % of charges	$385.14	$385.14	$385.14 – $385.14

Last updated: Sep 8, 2026

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