Physical therapy evaluation, low complexity at Mishawaka Medical Center

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 Pt Evaluation Low Complexity Patient/Family

Mishawaka, IN

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Pricing by billing methodology

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How this price compares nationally

Mishawaka Medical Center’s median price of $190 is 26% above the median hospital's median price ($150), higher than 65% of the 2,543 hospitals reporting CPT 97161. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 97161 at Mishawaka Medical Center

Negotiated rates from the hospital’s own file: 14 payers, 27 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 medicaid facility · fee schedule · both	$54.10	$54.10	$54.10 – $54.10
2	Blue Cross Blue Shield medicaid facility · fee schedule · both	$54.10	$54.10	$54.10 – $54.10
3	Molina medicaid facility · fee schedule · both	$54.10	$54.10	$54.10 – $54.10
4	UnitedHealthcare medicaid facility · fee schedule · both	$54.10	$54.10	$54.10 – $54.10
5	Anthem anthem bcbs medicare advantage facility · fee schedule · both	$92.90	$92.90	$92.90 – $92.90
6	Blue Cross Blue Shield anthem bcbs healthy medicare advantage facility · fee schedule · both	$92.90	$92.90	$92.90 – $92.90
7	UnitedHealthcare united healthcare medicare advantage facility · fee schedule · both	$94.76	$94.76	$94.76 – $94.76
8	Aetna aetna medicare advantage facility · fee schedule · both	$94.80	$94.80	$94.80 – $94.80
9	Aetna aetna marketplace facility · fee schedule · both	$146.94	$146.94	$146.94 – $146.94
10	Caresource caresource hmo marketplace facility · fee schedule · both	$146.94	$146.94	$146.94 – $146.94
11	UnitedHealthcare united healthcare charter facility · percent of total billed charges · bothfrom % of charges	$182.74	$182.74	$182.74 – $182.74
12	Anthem anthem bcbs medicaid hhw hcc facility · per diem · both	$186.46	$186.46	$186.46 – $186.46
13	Anthem anthem bcbs medicaid hip facility · per diem · both	$186.46	$186.46	$186.46 – $186.46
14	Caresource caresource medicaid facility · per diem · both	$186.46	$186.46	$186.46 – $186.46
15	UnitedHealthcare united healthcare medicaid facility · per diem · both	$186.46	$186.46	$186.46 – $186.46
16	Anthem anthem bcbs facility · fee schedule · both	$189.60	$189.60	$189.60 – $189.60
17	Blue Cross Blue Shield anthem bcbs facility · fee schedule · both	$189.60	$189.60	$189.60 – $189.60
18	Carefirst anthem bcbs facility · fee schedule · both	$189.60	$189.60	$189.60 – $189.60
19	Excellus anthem bcbs facility · fee schedule · both	$189.60	$189.60	$189.60 – $189.60
20	Highmark anthem bcbs facility · fee schedule · both	$189.60	$189.60	$189.60 – $189.60
21	Premera anthem bcbs facility · fee schedule · both	$189.60	$189.60	$189.60 – $189.60
22	Regence anthem bcbs facility · fee schedule · both	$189.60	$189.60	$189.60 – $189.60
23	Wellmark anthem bcbs facility · fee schedule · both	$189.60	$189.60	$189.60 – $189.60
24	UnitedHealthcare united healthcare facility · percent of total billed charges · bothfrom % of charges	$359.27	$359.27	$359.27 – $359.27
25	Cigna sagamore facility · percent of total billed charges · bothfrom % of charges	$360.96	$360.96	$360.96 – $360.96

Page 1 of 2 · 27 rates

Last updated: Mar 31, 2026

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