Outpatient office visit, established patient, level 4 at Champlain Valley Physicians Hospital 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 MOD MDM 30 MIN

Plattsburgh, NY

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Pricing by billing methodology

Price type

How this price compares nationally

Champlain Valley Physicians Hospital Medical Center’s median price of $131 is 18% below the median hospital's median price ($159), higher than 36% of the 2,010 hospitals reporting CPT 99214. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99214 at Champlain Valley Physicians Hospital Medical Center

Negotiated rates from the hospital’s own file: 7 payers, 32 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 managed medicaid/essential plans professional · fee schedule · both	$90.68	$90.68	$90.68 – $90.68
2	Aetna medicare advantage professional · fee schedule · both	$91.14	$91.14	$91.14 – $91.14
3	Blue Cross Blue Shield managed medicaid aliessa professional · fee schedule · both	$91.14	$91.14	$91.14 – $91.14
4	Blue Cross Blue Shield medicare advantage professional · fee schedule · both	$91.14	$91.14	$91.14 – $91.14
5	Excellus medicare advantage professional · fee schedule · both	$91.14	$91.14	$91.14 – $91.14
6	Humana tricare professional · fee schedule · both	$91.14	$91.14	$91.14 – $91.14
7	Excellus managed medicaid/essential plans professional · fee schedule · both	$98.32	$98.32	$98.32 – $98.32
8	Excellus managed medicaid/essential plans facility · percent of total billed charges · outpatientfrom % of charges	$102.00	$102.00	$102.00 – $102.00
9	Blue Cross Blue Shield essential plans/managed medicaid professional · fee schedule · both	$109.37	$109.37	$109.37 – $109.37
10	UnitedHealthcare medicare advantage professional · fee schedule · both	$120.91	$120.91	$120.91 – $120.91
11	Excellus commercial professional · fee schedule · both	$130.06	$130.06	$130.06 – $130.06
12	Highmark ind/fep professional · fee schedule · both	$131.27	$131.27	$131.27 – $131.27
13	Highmark ppo/hmo professional · fee schedule · both	$131.27	$131.27	$131.27 – $131.27
14	Aetna commercial professional · fee schedule · both	$133.98	$133.98	$133.98 – $133.98
15	Blue Cross Blue Shield individual network professional · fee schedule · both	$145.82	$145.82	$145.82 – $145.82
16	UnitedHealthcare commercial ppo for ny state employees professional · fee schedule · both	$164.23	$164.23	$150.91 – $177.54
17	Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$183.60	$183.60	$183.60 – $183.60
18	Blue Cross Blue Shield blue access professional · fee schedule · both	$204.95	$204.95	$204.95 – $204.95
19	Blue Cross Blue Shield hmo professional · fee schedule · both	$215.57	$215.57	$215.57 – $215.57
20	Blue Cross Blue Shield ind professional · fee schedule · both	$215.57	$215.57	$215.57 – $215.57
21	Blue Cross Blue Shield ppo professional · fee schedule · both	$215.57	$215.57	$215.57 – $215.57
22	UnitedHealthcare commercial professional · fee schedule · both	$287.88	$287.88	$287.88 – $287.88
23	Blue Cross Blue Shield blue access facility · percent of total billed charges · outpatientfrom % of charges	$311.10	$311.10	$311.10 – $311.10
24	Blue Cross Blue Shield hmo facility · percent of total billed charges · outpatientfrom % of charges	$326.40	$326.40	$326.40 – $326.40
25	Blue Cross Blue Shield ind facility · percent of total billed charges · outpatientfrom % of charges	$326.40	$326.40	$326.40 – $326.40

Page 1 of 2 · 32 rates

Last updated: Apr 28, 2026

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