Outpatient new patient office visit, high complexity at Hsa Pgh Llc

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

NEW PT LEVEL 5

Hialeah, FL

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Pricing by billing methodology

Price type

How this price compares nationally

Hsa Pgh Llc’s median price of $249 is 3% below the median hospital's median price ($257), higher than 48% of the 1,900 hospitals reporting CPT 99205. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99205 at Hsa Pgh Llc

Negotiated rates from the hospital’s own file: 11 payers, 23 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	Oscar oscar health plan hix facility · percent of total billed charges · outpatientfrom % of charges	$47	$47	—	—	—	$47 – $47
2	Aetna Better Health aetna better health medicaid hmo facility · fee schedule · outpatient	$132	$132	—	—	—	$132 – $132
3	Amerihealth Caritas amerihealth caritas medicaid facility · fee schedule · outpatient	$132	$132	—	—	—	$132 – $132
4	Humana humana medical plan / fl medicaid facility · fee schedule · outpatient	$132	$132	—	—	—	$132 – $132
5	UnitedHealthcare united healthcare medicaid hmo facility · fee schedule · outpatient	$134	$134	—	—	—	$134 – $134
6	Molina molina managed medicaid facility · other · outpatient	$136	$136	—	—	—	$136 – $136
7	UnitedHealthcare united healthcare of florida exchange facility · percent of total billed charges · outpatientfrom % of charges	$145	$145	—	—	—	$145 – $145
8	Aetna aetna non-gatekeeper facility · percent of total billed charges · outpatientfrom % of charges	$216	$216	—	—	—	$216 – $216
9	UnitedHealthcare united healthcare of florida all payer facility · percent of total billed charges · outpatientfrom % of charges	$220	$220	—	—	—	$220 – $220
10	UnitedHealthcare united healthcare of florida hmo facility · percent of total billed charges · outpatientfrom % of charges	$220	$220	—	—	—	$220 – $220
11	UnitedHealthcare united healthcare of florida ppo facility · percent of total billed charges · outpatientfrom % of charges	$220	$220	—	—	—	$220 – $220
12	Humana humana commercial hmo facility · other · outpatient	$238	$238	—	—	—	$238 – $238
13	Humana humana commercial ppo facility · other · outpatient	$249	$249	—	—	—	$249 – $249
14	Cigna cigna behavioral health facility · percent of total billed charges · inpatientfrom % of charges	$306	$306	—	—	—	$306 – $306
15	Cigna cigna behavioral health facility · percent of total billed charges · outpatientfrom % of charges	$306	$306	—	—	—	$306 – $306
16	Aetna aetna signature administrators (asa) facility · percent of total billed charges · inpatientfrom % of charges	$349	$349	—	—	—	$349 – $349
17	Aetna aetna signature administrators (asa) facility · percent of total billed charges · outpatientfrom % of charges	$349	$349	—	—	—	$349 – $349
18	Magellan magellan behavioral health facility · percent of total billed charges · outpatientfrom % of charges	$368	$368	—	—	—	$368 – $368
19	First Health first health facility · percent of total billed charges · inpatientfrom % of charges	$410	$410	—	—	—	$410 – $410
20	First Health first health facility · percent of total billed charges · outpatientfrom % of charges	$410	$410	—	—	—	$410 – $410
21	Tricare tricare traditional facility · percent of total billed charges · outpatientfrom % of charges	$429	$429	—	—	—	$429 – $429
22	UnitedHealthcare united healthcare of florida all payer facility · per diem · outpatient	$2.0k	$2.0k	—	—	—	$2.0k – $2.0k
23	UnitedHealthcare united healthcare of florida ppo facility · per diem · outpatient	$2.2k	$2.2k	—	—	—	$2.2k – $2.2k

Last updated: Sep 1, 2026

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