Outpatient office visit, established patient at Caldwell Memorial Hospital

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 ESTABLISHED PATIENT LEVEL 3

Lenoir, NC

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Pricing by billing methodology

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How this price compares nationally

Caldwell Memorial Hospital’s median price of $111 is 10% below the median hospital's median price ($124), higher than 45% 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 Caldwell Memorial Hospital

Negotiated rates from the hospital’s own file: 7 payers, 16 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	Amerihealth Caritas managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$85.55	$85.55	$85.55 – $85.55
2	UnitedHealthcare chip/medicaid facility · percent of total billed charges · outpatientfrom % of charges	$85.55	$85.55	$85.55 – $85.55
3	WellCare managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$85.55	$85.55	$85.55 – $85.55
4	UnitedHealthcare commercial facility · per diem · outpatient	$103.00	$103.00	$103.00 – $103.00
5	Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$111.16	$111.16	$111.16 – $111.16
6	Medcost ultra facility · percent of total billed charges · inpatientfrom % of charges	$127.04	$127.04	$127.04 – $127.04
7	UnitedHealthcare individual exchange facility · percent of total billed charges · outpatientfrom % of charges	$144.51	$144.51	$144.51 – $144.51
8	Blue Cross Blue Shield blue value facility · percent of total billed charges · outpatientfrom % of charges	$152.77	$152.77	$152.77 – $152.77
9	Medcost commercial facility · percent of total billed charges · inpatientfrom % of charges	$179.05	$179.05	$179.05 – $179.05
10	Aetna north carolina preferred facility · percent of total billed charges · outpatientfrom % of charges	$210.41	$210.41	$210.41 – $210.41
11	Blue Cross Blue Shield blue select/hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges	$215.41	$215.41	$215.41 – $215.41
12	Medcost commercial facility · percent of total billed charges · outpatientfrom % of charges	$231.05	$231.05	$231.05 – $231.05
13	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$234.23	$234.23	$234.23 – $234.23
14	Medcost ultra facility · percent of total billed charges · outpatientfrom % of charges	$261.23	$261.23	$261.23 – $261.23
15	Cigna commercial facility · percent of total billed charges · inpatientfrom % of charges	$317.60	$317.60	$317.60 – $317.60
16	Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges	$317.60	$317.60	$317.60 – $317.60

Last updated: Jun 4, 2026

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