Outpatient new patient office visit, high complexity at MaineHealth

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

HC OFFICE/OUTPT NEW LEV 5

Biddeford, ME

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Pricing by billing methodology

Price type

How this price compares nationally

MaineHealth’s median price of $417 is 63% above the median hospital's median price ($257), higher than 75% 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 MaineHealth

Negotiated rates from the hospital’s own file: 7 payers, 28 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	Aetna medicare advantage fee schedule · outpatient	$125	$125	—	—	—	$125 – $125
2	Humana medicare advantage fee schedule · outpatient	$125	$125	—	—	—	$125 – $125
3	UnitedHealthcare medicare advantage fee schedule · outpatient	$125	$125	—	—	—	$125 – $125
4	Anthem medicare advantage fee schedule · outpatient	$126	$126	—	—	—	$126 – $126
5	WellCare medicare advantage fee schedule · outpatient	$128	$128	—	—	—	$128 – $128
6	UnitedHealthcare medicare advantage case rate · both	$172	$172	—	—	—	$172 – $172
7	Anthem medicare advantage case rate · both	$174	$174	—	—	—	$174 – $174
8	Aetna medicare advantage case rate · both	$176	$176	—	—	—	$176 – $176
9	Humana medicare advantage case rate · both	$198	$198	—	—	—	$198 – $198
10	WellCare medicare advantage case rate · both	$198	$198	—	—	—	$198 – $198
11	Aetna hmo fee schedule · both	$240	$240	—	—	—	$240 – $240
12	Aetna ppo fee schedule · both	$240	$240	—	—	—	$240 – $240
13	MultiPlan commercial fee schedule · both	$336	$336	—	—	—	$336 – $336
14	Anthem hmo/pos/ppo/pathway enhanced fee schedule · both	$336	$336	—	—	—	$336 – $336
15	UnitedHealthcare commercial fee schedule · both	$353	$353	—	—	—	$353 – $353
16	Cigna oap fee schedule · both	$394	$394	—	—	—	$394 – $394
17	Cigna ppo fee schedule · both	$394	$394	—	—	—	$394 – $394
18	Aetna hmo percent of total billed charges · inpatientfrom % of charges	$462	$462	—	—	—	$462 – $462
19	Aetna hmo percent of total billed charges · outpatientfrom % of charges	$462	$462	—	—	—	$462 – $462
20	Cigna oap percent of total billed charges · inpatientfrom % of charges	$467	$467	—	—	—	$467 – $467
21	Aetna ppo percent of total billed charges · inpatientfrom % of charges	$478	$478	—	—	—	$478 – $478
22	Aetna ppo percent of total billed charges · outpatientfrom % of charges	$478	$478	—	—	—	$478 – $478
23	Cigna ppo percent of total billed charges · inpatientfrom % of charges	$478	$478	—	—	—	$478 – $478
24	UnitedHealthcare commercial percent of total billed charges · inpatientfrom % of charges	$518	$518	—	—	—	$518 – $518
25	UnitedHealthcare commercial percent of total billed charges · outpatientfrom % of charges	$518	$518	—	—	—	$518 – $518

Page 1 of 2 · 28 rates

Last updated: Sep 9, 2025

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