Outpatient office visit, established patient, level 5 at Berkshire 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

Eval Est Pt Lvl 5 40m Wound

Pittsfield, MA

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Pricing by billing methodology

Price type

How this price compares nationally

Berkshire Medical Center’s median price of $254 is 21% above the median hospital's median price ($210), higher than 62% of the 1,976 hospitals reporting CPT 99215. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99215 at Berkshire Medical Center

Negotiated rates from the hospital’s own file: 8 payers, 33 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	Blue Cross Blue Shield comm blue cross ma hmo facility · fee schedule · outpatient	$164.54	$164.54	$164.54 – $164.54
2	Blue Cross Blue Shield comm blue cross ma indem facility · fee schedule · outpatient	$164.54	$164.54	$164.54 – $164.54
3	Blue Cross Blue Shield comm blue cross ma ppo facility · fee schedule · outpatient	$164.54	$164.54	$164.54 – $164.54
4	Medicare mcr traditional medicare professional · fee schedule · outpatient	$194.17	$194.17	$194.17 – $194.17
5	Medicare mcrmanaged medicare hmo professional · fee schedule · outpatient	$194.17	$194.17	$194.17 – $194.17
6	UnitedHealthcare mcrmanaged united vaccn professional · fee schedule · outpatient	$197.33	$197.33	$197.33 – $197.33
7	UnitedHealthcare mcrmanaged united vaccn bh professional · fee schedule · outpatient	$197.33	$197.33	$197.33 – $197.33
8	Medicaid mcd masshealth facility · fee schedule · outpatient	$203.51	$203.51	$203.51 – $203.51
9	Medicaid mcdmanaged medicaid acos facility · fee schedule · outpatient	$203.51	$203.51	$203.51 – $203.51
10	Blue Cross Blue Shield mcrmanaged blue cross vt medicare hmo professional · fee schedule · outpatient	$203.88	$203.88	$203.88 – $203.88
11	UnitedHealthcare comm united bh facility · percent of total billed charges · inpatientfrom % of charges	$207.69	$259.45	$87.75 – $534.68
12	Blue Cross Blue Shield comm blue cross vt ppo facility · percent of total billed charges · inpatientfrom % of charges	$230.06	$287.39	$97.20 – $592.26
13	Aetna comm aetna facility · percent of total billed charges · inpatientfrom % of charges	$236.45	$295.38	$99.90 – $608.72
14	UnitedHealthcare comm united bh facility · percent of total billed charges · outpatientfrom % of charges	$241.51	$316.69	$173.87 – $534.68
15	UnitedHealthcare comm united bh professional · fee schedule · outpatient	$241.51	$316.69	$173.87 – $534.68
16	UnitedHealthcare comm unitedhealthcare facility · percent of total billed charges · inpatientfrom % of charges	$274.79	$343.28	$116.10 – $707.43
17	Blue Cross Blue Shield comm blue cross vt ppo facility · percent of total billed charges · outpatientfrom % of charges	$267.52	$350.79	$192.59 – $592.26
18	Aetna comm aetna facility · percent of total billed charges · outpatientfrom % of charges	$274.95	$360.54	$197.94 – $608.72
19	First Health comm first health facility · percent of total billed charges · inpatientfrom % of charges	$303.55	$379.20	$128.25 – $781.46
20	Phcs comm phcs facility · percent of total billed charges · inpatientfrom % of charges	$303.55	$379.20	$128.25 – $781.46
21	Blue Cross Blue Shield comm blue cross vt ppo professional · fee schedule · outpatient	$315.83	$414.13	$227.37 – $699.20
22	UnitedHealthcare comm unitedhealthcare facility · percent of total billed charges · outpatientfrom % of charges	$319.54	$419.00	$230.04 – $707.43
23	UnitedHealthcare comm unitedhealthcare professional · fee schedule · outpatient	$319.54	$419.00	$230.04 – $707.43
24	Cigna comm cigna carelink professional · fee schedule · outpatient	$334.40	$438.49	$240.74 – $740.33
25	Cigna comm cigna hmo pos professional · fee schedule · outpatient	$334.40	$438.49	$240.74 – $740.33

Page 1 of 2 · 33 rates

Last updated: Oct 9, 2026

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