Initial hospital stay evaluation, low complexity at Mount Carmel Dublin

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

PR Hospital IP/Obs Care Initial Straightforward or Low Level per Day

Dublin, OH

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How this price compares nationally

Mount Carmel Dublin’s median price of $175 is 45% above the median hospital's median price ($121), higher than 68% of the 1,281 hospitals reporting CPT 99221. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99221 at Mount Carmel Dublin

Negotiated rates from the hospital’s own file: 33 payers, 72 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 aetna medicare advantage professional · fee schedule · inpatient	$72	$72	—	—	—	$72 – $72
2	Aetna aetna medicare advantage professional · fee schedule · outpatient	$72	$72	—	—	—	$72 – $72
3	Humana tricare professional · fee schedule · inpatient	$78	$78	—	—	—	$78 – $78
4	Humana tricare professional · fee schedule · outpatient	$78	$78	—	—	—	$78 – $78
5	Tricare tricare professional · fee schedule · inpatient	$78	$78	—	—	—	$78 – $78
6	Tricare tricare professional · fee schedule · outpatient	$78	$78	—	—	—	$78 – $78
7	UnitedHealthcare united healthcare professional · fee schedule · inpatient	$151	$151	—	—	—	$151 – $151
8	UnitedHealthcare united healthcare professional · fee schedule · outpatient	$151	$151	—	—	—	$151 – $151
9	Aetna pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
10	Ambetter pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
11	Amerihealth Caritas pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
12	Anthem pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
13	Blue Cross Blue Shield pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
14	Carefirst pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
15	Caresource pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
16	Cigna pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
17	Clover pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
18	Devoted pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
19	Excellus pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
20	First Health pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
21	Highmark pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
22	Humana pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
23	Kaiser pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
24	Magellan pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175
25	Medcost pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$175	$175	—	—	—	$175 – $175

Page 1 of 3 · 72 rates

Last updated: Mar 31, 2026

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