Outpatient specialist consultation, high complexity visit at Mercy Hospital Springfield

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/Est Office/OP Cnslt High 55-69 Min Pf

Ozark, MO

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Pricing by billing methodology

Price type

How this price compares nationally

Mercy Hospital Springfield’s median price of $153 is 41% below the median hospital's median price ($261), higher than 16% of the 1,112 hospitals reporting CPT 99245. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99245 at Mercy Hospital Springfield

Negotiated rates from the hospital’s own file: 15 payers, 24 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	Medicaid hb sprg/jopl ark medicaid facility · case rate · outpatient	$5	$5	—	—	—	$5 – $5
2	Medica hb sprg lebn medica exchange facility · percent of total billed charges · outpatientfrom % of charges	$109	$109	$7	7%	—	$100 – $118
3	Ambetter hb sprg ambetter exchange mo facility · percent of total billed charges · outpatientfrom % of charges	$112	$112	$9	8%	—	$103 – $121
4	Medicare hb sprg medicare facility · fee schedule · outpatient	$120	$120	—	—	—	$120 – $120
5	Tricare hb sprg tricare facility · fee schedule · outpatient	$120	$120	—	—	—	$120 – $120
6	WellCare hb sprg & lebn wellcare mcr 103% facility · fee schedule · outpatient	$126	$126	—	—	—	$126 – $126
7	Aetna hb sprg aetna commercial facility · percent of total billed charges · outpatientfrom % of charges	$138	$138	$9	7%	—	$127 – $149
8	Anthem hb sprg anthem alliance facility · percent of total billed charges · outpatientfrom % of charges	$138	$138	$11	8%	—	$127 – $149
9	Anthem hb sprg anthem blue access facility · percent of total billed charges · outpatientfrom % of charges	$138	$138	$11	8%	—	$127 – $149
10	Blue Cross Blue Shield hb sprg anthem alliance facility · percent of total billed charges · outpatientfrom % of charges	$138	$138	$11	8%	—	$127 – $149
11	Blue Cross Blue Shield hb sprg anthem blue access facility · percent of total billed charges · outpatientfrom % of charges	$138	$138	$11	8%	—	$127 – $149
12	Blue Cross Blue Shield hb sprg anthem pathways exchange facility · percent of total billed charges · outpatientfrom % of charges	$138	$138	$11	8%	—	$127 – $149
13	Optum hb sprg uhc all payer facility · percent of total billed charges · outpatientfrom % of charges	$146	$146	—	—	—	$146 – $146
14	UnitedHealthcare hb sprg uhc all payer facility · percent of total billed charges · outpatientfrom % of charges	$146	$146	—	—	—	$146 – $146
15	UnitedHealthcare hb sprg uhc individual exchange facility · percent of total billed charges · outpatientfrom % of charges	$146	$146	—	—	—	$146 – $146
16	UnitedHealthcare hb sprg uhc options ppo facility · percent of total billed charges · outpatientfrom % of charges	$146	$146	—	—	—	$146 – $146
17	First Health hb sprg aetna first health-network access facility · percent of total billed charges · outpatientfrom % of charges	$155	$155	$10	7%	—	$142 – $167
18	Humana hb sprg humana facility · percent of total billed charges · outpatientfrom % of charges	$188	$188	$12	7%	—	$173 – $203
19	Cigna hb sprg cigna hmo facility · percent of total billed charges · outpatientfrom % of charges	$190	$190	$12	7%	—	$175 – $206
20	Blue Cross Blue Shield hb sprg anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges	$201	$201	$16	8%	—	$185 – $217
21	Blue Cross Blue Shield hb sprg anthem traditional facility · percent of total billed charges · outpatientfrom % of charges	$211	$211	$17	8%	—	$194 – $228
22	Cigna hb sprg cigna ppo facility · percent of total billed charges · outpatientfrom % of charges	$213	$213	$14	7%	—	$196 – $229
23	MultiPlan hb sprg phcs (mpi) facility · percent of total billed charges · outpatientfrom % of charges	$213	$213	$14	7%	—	$196 – $229
24	Ambetter hb sprg ambetter exchange mo facility · case rate · outpatient	$3.3k	$3.3k	—	—	—	$3.3k – $3.3k

Last updated: Jun 4, 2026

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