Outpatient office visit, established patient, level 4 at Elizabethtown Community 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 MOD MDM 30 MIN

Elizabethtown, NY

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Pricing by billing methodology

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How this price compares nationally

Elizabethtown Community Hospital’s median price of $121 is 24% below the median hospital's median price ($159), higher than 30% 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 Elizabethtown Community Hospital

Negotiated rates from the hospital’s own file: 7 payers, 18 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	Humana tricare professional · fee schedule · both	$86.58	$86.58	$86.58 – $86.58
2	UnitedHealthcare managed medicaid/essential plans professional · fee schedule · both	$90.68	$90.68	$90.68 – $90.68
3	Aetna medicare advantage professional · fee schedule · both	$91.14	$91.14	$91.14 – $91.14
4	Blue Cross Blue Shield managed medicaid aliessa professional · fee schedule · both	$91.14	$91.14	$91.14 – $91.14
5	Blue Cross Blue Shield medicare advantage professional · fee schedule · both	$91.14	$91.14	$91.14 – $91.14
6	Excellus medicare advantage 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	Blue Cross Blue Shield essential plans/non-aliessa managed medicaid professional · fee schedule · both	$109.37	$109.37	$109.37 – $109.37
9	UnitedHealthcare medicare advantage professional · fee schedule · both	$120.91	$120.91	$120.91 – $120.91
10	Excellus commercial professional · fee schedule · both	$130.06	$130.06	$130.06 – $130.06
11	Highmark ind/fep/ppo/hmo professional · fee schedule · both	$131.27	$131.27	$131.27 – $131.27
12	Aetna commercial professional · fee schedule · both	$135.27	$135.27	$135.27 – $135.27
13	Blue Cross Blue Shield individual network professional · fee schedule · both	$145.82	$145.82	$145.82 – $145.82
14	UnitedHealthcare commercial ppo for ny state employees professional · fee schedule · both	$150.45	$150.45	$138.25 – $162.65
15	Blue Cross Blue Shield blue access professional · fee schedule · both	$193.27	$193.27	$193.27 – $193.27
16	Blue Cross Blue Shield hmo/pos/epo/ppo/ind professional · fee schedule · both	$203.88	$203.88	$203.88 – $203.88
17	UnitedHealthcare commercial professional · fee schedule · both	$287.88	$287.88	$287.88 – $287.88
18	MultiPlan group health professional · percent of total billed charges · bothfrom % of charges	$371.70	$371.70	$371.70 – $371.70

Last updated: Apr 28, 2026

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