Outpatient office visit, established patient at Porter Hospital Inc

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 OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN

Middlebury, VT

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Pricing by billing methodology

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How this price compares nationally

Porter Hospital Inc’s median price of $116 is 7% below the median hospital's median price ($124), higher than 47% of the 2,009 hospitals reporting CPT 99213. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 99213 at Porter Hospital Inc

Negotiated rates from the hospital’s own file: 7 payers, 20 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	Humana tricare professional · fee schedule · both	$58.93	$58.93	$58.93 – $58.93
2	Aetna medicare advantage professional · fee schedule · both	$62.03	$62.03	$62.03 – $62.03
3	UnitedHealthcare managed medicaid/essential plans professional · fee schedule · both	$64.40	$64.40	$64.40 – $64.40
4	Bcbs Vt medicare advantage professional · fee schedule · both	$71.33	$71.33	$71.33 – $71.33
5	Cigna commercial professional · fee schedule · both	$77.77	$77.77	$77.77 – $77.77
6	UnitedHealthcare medicare advantage professional · fee schedule · both	$87.09	$87.09	$87.09 – $87.09
7	Bcbs Vt indemnity/the vermont health plan/vermont health partnership professional · fee schedule · both	$98.43	$98.43	$95.56 – $101.29
8	UnitedHealthcare commercial ppo for ny state employees professional · fee schedule · both	$111.59	$111.59	$102.54 – $120.64
9	Blue Cross Blue Shield hmo professional · percent of total billed charges · bothfrom % of charges	$114.33	$114.33	$114.33 – $114.33
10	Aetna medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$115.62	$115.62	$115.62 – $115.62
11	UnitedHealthcare medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$115.62	$115.62	$115.62 – $115.62
12	Bcbs Vt medicare advantage facility · percent of total billed charges · outpatientfrom % of charges	$118.08	$118.08	$118.08 – $118.08
13	MultiPlan group health professional · percent of total billed charges · bothfrom % of charges	$140.60	$140.60	$140.60 – $140.60
14	Bcbs Vt indemnity facility · fee schedule · outpatient	$167.28	$167.28	$167.28 – $167.28
15	Bcbs Vt the vermont health plan/vermont health partnership facility · fee schedule · outpatient	$167.28	$167.28	$167.28 – $167.28
16	Blue Cross Blue Shield hmo facility · percent of total billed charges · outpatientfrom % of charges	$191.88	$191.88	$191.88 – $191.88
17	UnitedHealthcare commercial professional · fee schedule · both	$195.26	$195.26	$195.26 – $195.26
18	Cigna commercial facility · percent of total billed charges · outpatientfrom % of charges	$223.74	$223.74	$223.74 – $223.74
19	MultiPlan group health facility · percent of total billed charges · outpatientfrom % of charges	$233.70	$233.70	$233.70 – $233.70
20	UnitedHealthcare commercial facility · percent of total billed charges · outpatientfrom % of charges	$243.54	$243.54	$243.54 – $243.54

Last updated: Apr 28, 2026

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