Outpatient new patient office visit, high complexity at Essentia Health Duluth

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

OFFICE/OUTPT VISIT,NEW,LEVL V

Duluth, MN

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Pricing by billing methodology

Price type

How this price compares nationally

Essentia Health Duluth’s median price of $247 is 4% below the median hospital's median price ($257), higher than 48% of the 1,937 hospitals reporting CPT 99205. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99205 at Essentia Health Duluth

Negotiated rates from the hospital’s own file: 8 payers, 26 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	Medica medicaid facility · percent of total billed charges · outpatientfrom % of charges	$115	$115	—	—	—	$115 – $115
2	Healthpartners medicaid facility · percent of total billed charges · outpatientfrom % of charges	$138	$138	—	—	—	$138 – $138
3	Blue Cross Blue Shield medicaid facility · percent of total billed charges · outpatientfrom % of charges	$143	$143	—	—	—	$143 – $143
4	Blue Cross Blue Shield shp facility · percent of total billed charges · inpatientfrom % of charges	$143	$143	—	—	—	$143 – $143
5	Blue Cross Blue Shield shp facility · percent of total billed charges · outpatientfrom % of charges	$143	$143	—	—	—	$143 – $143
6	Sanford Health Plan commercia-ndpers facility · percent of total billed charges · inpatientfrom % of charges	$148	$148	—	—	—	$148 – $148
7	Sanford Health Plan commercia-ndpers facility · percent of total billed charges · outpatientfrom % of charges	$148	$148	—	—	—	$148 – $148
8	Blue Cross Blue Shield bcbs mn facility · percent of total billed charges · outpatientfrom % of charges	$156	$156	—	—	—	$156 – $156
9	Sanford Health Plan commercial facility · percent of total billed charges · inpatientfrom % of charges	$156	$156	—	—	—	$156 – $156
10	Sanford Health Plan commercial facility · percent of total billed charges · outpatientfrom % of charges	$156	$156	—	—	—	$156 – $156
11	Medica commercial-fi facility · percent of total billed charges · outpatientfrom % of charges	$191	$191	—	—	—	$191 – $191
12	Medica commercial-si facility · percent of total billed charges · outpatientfrom % of charges	$197	$197	—	—	—	$197 – $197
13	Medica commercial facility · percent of total billed charges · outpatientfrom % of charges	$201	$201	$10	5%	—	$191 – $211
14	Blue Cross Blue Shield medicaid facility · percent of total billed charges · inpatientfrom % of charges	$208	$208	—	—	—	$208 – $208
15	Ucare commercial facility · percent of total billed charges · inpatientfrom % of charges	$228	$228	—	—	—	$228 – $228
16	Ucare commercial facility · percent of total billed charges · outpatientfrom % of charges	$228	$228	—	—	—	$228 – $228
17	Blue Cross Blue Shield bcbs mn facility · percent of total billed charges · inpatientfrom % of charges	$231	$231	—	—	—	$231 – $231
18	Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges	$247	$247	—	—	—	$247 – $247
19	Healthpartners commercial facility · percent of total billed charges · outpatientfrom % of charges	$247	$247	—	—	—	$247 – $247
20	Healthpartners shp facility · percent of total billed charges · outpatientfrom % of charges	$247	$247	—	—	—	$247 – $247
21	UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges	$253	$253	—	—	—	$253 – $253
22	Blue Cross Blue Shield commercial facility · percent of total billed charges · inpatientfrom % of charges	$263	$263	—	—	—	$263 – $263
23	Blue Cross Blue Shield commercial facility · percent of total billed charges · outpatientfrom % of charges	$263	$263	—	—	—	$263 – $263
24	Aetna commercial facility · percent of total billed charges · inpatientfrom % of charges	$294	$294	—	—	—	$294 – $294
25	Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$294	$294	—	—	—	$294 – $294

Page 1 of 2 · 26 rates

Last updated: Jan 1, 2026

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