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.
Original text from hospital filings
HC ACB ESTABLISHED PT LEVEL 4
South Haven, MI
See all hospitals reporting CPT 99214 →Price type
Bronson South Haven Hospital’s median price of $258 is 62% above the median hospital's median price ($159), higher than 75% of the 2,010 hospitals reporting CPT 99214. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
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 | UnitedHealthcare medicaid professional · fee schedule · both | $74.36 | $74.36 | $74.36 – $74.36 |
| 2 | Blue Cross Blue Shield complete professional · fee schedule · both | $78.08 | $78.08 | $78.08 – $78.08 |
| 3 | Aetna medicare professional · fee schedule · both | $83.74 | $83.74 | $83.74 – $83.74 |
| 4 | Blue Cross Blue Shield mappo professional · fee schedule · both | $83.74 | $83.74 | $83.74 – $83.74 |
| 5 | UnitedHealthcare dual complete dsnp/medicare advantage professional · fee schedule · both | $83.74 | $83.74 | $83.74 – $83.74 |
| 6 | Molina medicare/medicaid professional · fee schedule · both | $92.11 | $92.11 | $92.11 – $92.11 |
| 7 | UnitedHealthcare all payor (choice/ppo) + core professional · fee schedule · both | $111.57 | $111.57 | $111.57 – $111.57 |
| 8 | UnitedHealthcare exchange professional · fee schedule · both | $111.57 | $111.57 | $111.57 – $111.57 |
| 9 | Aetna commercial professional · fee schedule · both | $112.21 | $112.21 | $112.21 – $112.21 |
| 10 | Aetna medicare facility · percent of total billed charges · outpatientfrom % of charges | $217.91 | $217.91 | $112.25 – $323.57 |
| 11 | Blue Cross Blue Shield complete facility · percent of total billed charges · outpatientfrom % of charges | $235.58 | $235.58 | $121.35 – $349.81 |
| 12 | Blue Cross Blue Shield trust/ppo facility · percent of total billed charges · inpatientfrom % of charges | $483.65 | $483.65 | $249.13 – $718.16 |
| 13 | Blue Cross Blue Shield trust/ppo facility · percent of total billed charges · outpatientfrom % of charges | $485.59 | $485.59 | $250.13 – $721.04 |
| 14 | MultiPlan commercial facility · percent of total billed charges · inpatientfrom % of charges | $500.60 | $500.60 | $257.86 – $743.34 |
| 15 | MultiPlan commercial facility · percent of total billed charges · outpatientfrom % of charges | $500.60 | $500.60 | $257.86 – $743.34 |
| 16 | UnitedHealthcare all payor (choice/ppo) + core facility · percent of total billed charges · inpatientfrom % of charges | $518.28 | $518.28 | $266.97 – $769.58 |
| 17 | UnitedHealthcare all payor (choice/ppo) + core facility · percent of total billed charges · outpatientfrom % of charges | $518.28 | $518.28 | $266.97 – $769.58 |
| 18 | Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges | $530.05 | $530.05 | $273.03 – $787.07 |
| 19 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $530.05 | $530.05 | $273.03 – $787.07 |
Last updated: Aug 3, 2026
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