Outpatient office visit, established patient at Columbia 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

PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN

Hudson, NY

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Pricing by billing methodology

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How this price compares nationally

Columbia Memorial Hospital’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 Columbia Memorial Hospital

Negotiated rates from the hospital’s own file: 7 payers, 58 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_fac professional · fee schedule · outpatient	$30.82	$30.82	$30.82 – $30.82
2	UnitedHealthcare medicaid_nonfac professional · fee schedule · outpatient	$43.38	$43.38	$43.38 – $43.38
3	Blue Cross Blue Shield pathway enhanced_fac professional · fee schedule · outpatient	$53.00	$53.00	$53.00 – $53.00
4	UnitedHealthcare all products_nonmd_fac professional · fee schedule · outpatient	$54.59	$54.59	$54.59 – $54.59
5	Blue Cross Blue Shield essentialaliessa-medicaid-chp-harp_ancillary providers_fac professional · fee schedule · outpatient	$58.21	$58.21	$58.21 – $58.21
6	Tricare all products_nonphysician_fac professional · fee schedule · outpatient	$58.21	$58.21	$58.21 – $58.21
7	Blue Cross Blue Shield essentialnonaliessa_ancillary providers_fac professional · fee schedule · outpatient	$64.03	$64.03	$64.03 – $64.03
8	UnitedHealthcare all products_md_fac professional · fee schedule · outpatient	$64.22	$64.22	$64.22 – $64.22
9	Blue Cross Blue Shield blue access_fac professional · fee schedule · outpatient	$66.25	$66.25	$66.25 – $66.25
10	Blue Cross Blue Shield hmo_fac professional · fee schedule · outpatient	$66.25	$66.25	$66.25 – $66.25
11	Blue Cross Blue Shield medicare_fac professional · fee schedule · outpatient	$66.25	$66.25	$66.25 – $66.25
12	Blue Cross Blue Shield ppo_fac professional · fee schedule · outpatient	$66.25	$66.25	$66.25 – $66.25
13	Cigna commercial_specialist_fac professional · fee schedule · outpatient	$66.89	$66.89	$66.89 – $66.89
14	Blue Cross Blue Shield essentialaliessa-medicaid-chp-harp_md_fac professional · fee schedule · outpatient	$68.48	$68.48	$68.48 – $68.48
15	Tricare all products_physician_fac professional · fee schedule · outpatient	$68.48	$68.48	$68.48 – $68.48
16	UnitedHealthcare medicare_fac professional · fee schedule · outpatient	$68.48	$68.48	$68.48 – $68.48
17	Cigna commercial_pcp_fac professional · fee schedule · outpatient	$69.12	$69.12	$69.12 – $69.12
18	Aetna medicare_fac professional · fee schedule · outpatient	$70.53	$70.53	$70.53 – $70.53
19	Blue Cross Blue Shield pathway enhanced_nonfac professional · fee schedule · outpatient	$73.61	$73.61	$73.61 – $73.61
20	Blue Cross Blue Shield essentialnonaliessa_md_fac professional · fee schedule · outpatient	$75.33	$75.33	$75.33 – $75.33
21	UnitedHealthcare all products_nonmd_nonfac professional · fee schedule · outpatient	$79.95	$79.95	$79.95 – $79.95
22	Blue Cross Blue Shield essentialaliessa-medicaid-chp-harp_ancillary providers_nonfac professional · fee schedule · outpatient	$81.93	$81.93	$81.93 – $81.93
23	Tricare all products_nonphysician_nonfac professional · fee schedule · outpatient	$81.93	$81.93	$81.93 – $81.93
24	UnitedHealthcare all products_fac professional · fee schedule · outpatient	$82.18	$82.18	$82.18 – $82.18
25	Aetna all products_fac professional · fee schedule · outpatient	$82.86	$82.86	$82.86 – $82.86

Page 1 of 3 · 58 rates

Last updated: Dec 31, 2025

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