Outpatient office visit, established patient, level 5 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 HIGH MDM 40 MIN

Elizabethtown, NY

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How this price compares nationally

Elizabethtown Community Hospital’s median price of $170 is 19% below the median hospital's median price ($210), higher than 37% of the 1,976 hospitals reporting CPT 99215. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99215 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	UnitedHealthcare managed medicaid/essential plans professional · fee schedule · both	$127.37	$127.37	$127.37 – $127.37
2	Humana tricare professional · fee schedule · both	$128.09	$128.09	$128.09 – $128.09
3	Aetna medicare advantage professional · fee schedule · both	$134.83	$134.83	$134.83 – $134.83
4	Blue Cross Blue Shield managed medicaid aliessa professional · fee schedule · both	$134.83	$134.83	$134.83 – $134.83
5	Blue Cross Blue Shield medicare advantage professional · fee schedule · both	$134.83	$134.83	$134.83 – $134.83
6	Excellus medicare advantage professional · fee schedule · both	$134.83	$134.83	$134.83 – $134.83
7	Excellus managed medicaid/essential plans professional · fee schedule · both	$139.06	$139.06	$139.06 – $139.06
8	Blue Cross Blue Shield essential plans/non-aliessa managed medicaid professional · fee schedule · both	$161.80	$161.80	$161.80 – $161.80
9	UnitedHealthcare medicare advantage professional · fee schedule · both	$169.83	$169.83	$169.83 – $169.83
10	Highmark ind/fep/ppo/hmo professional · fee schedule · both	$176.46	$176.46	$176.46 – $176.46
11	Excellus commercial professional · fee schedule · both	$183.10	$183.10	$183.10 – $183.10
12	Aetna commercial professional · fee schedule · both	$200.54	$200.54	$200.54 – $200.54
13	Blue Cross Blue Shield individual network professional · fee schedule · both	$215.73	$215.73	$215.73 – $215.73
14	UnitedHealthcare commercial ppo for ny state employees professional · fee schedule · both	$219.61	$219.61	$201.81 – $237.41
15	Blue Cross Blue Shield blue access professional · fee schedule · both	$258.91	$258.91	$258.91 – $258.91
16	Blue Cross Blue Shield hmo/pos/epo/ppo/ind professional · fee schedule · both	$273.14	$273.14	$273.14 – $273.14
17	UnitedHealthcare commercial professional · fee schedule · both	$403.71	$403.71	$403.71 – $403.71
18	MultiPlan group health professional · percent of total billed charges · bothfrom % of charges	$523.80	$523.80	$523.80 – $523.80

Last updated: Apr 28, 2026

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