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Office visit, new patient, 45-59 min

CPT 99204 · negotiated-rate distribution across hospitals in KY

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Hospitals
10
Min
$83.64
Median
$114.34
Max
$742.99
Range multiplier
8.9×

By payer (22 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Aetna957$25.99$128.08$1,077.8741.5×
Anthem BCBS840$25.99$167.88$1,013.3139.0×
WellCare939$30.94$114.34$289.759.4×
UnitedHealthcare932$25.99$114.34$863.4633.2×
Humana822$25.99$83.64$295.2811.4×
caresoure kentucky721$109.2$188.66$695.46.4×
umr814$80.99$244.72$863.4610.7×
optum ccn region 2713$30.94$114.34$114.343.7×
optum ccn region 1713$30.94$114.34$114.343.7×
Molina711$25.99$85.31$213.638.2×
the health plan14$100.62$107.48$114.341.1×
Cigna13$123.81$153.88$233.621.9×
alliance coal12$148.57$189.7$230.821.6×
CareSource12$123.81$165.78$207.741.7×
Multiplan12$261.6$262.55$263.51.0×
va community care network12$123.81$138.85$153.881.2×
amerigroup12$123.81$138.85$153.881.2×
christian county health dept-cchd11$102.79$102.79$102.791.0×
center care11$233.62$233.62$233.621.0×
beacon health11$102.79$102.79$102.791.0×
First Health11$263.5$263.5$263.51.0×
commonwealth health alliance11$279$279$2791.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
MCDOWELL ARHMCDOWELLKY10$492$295.2$30.94$83.64$432.96
HARLAN ARHHARLANKY8$1,104$662.4$176.64$742.99$1,026.72
MIDDLESBORO ARHMIDDLESBOROKY10$1,159$695.4$33.42$200.73$1,077.87
JENNIE STUART MEDICAL CENTERHOPKINSVILLEKY16$310$96.1$102.79$153.88$295.28
HAZARD ARHHAZARDKY10$952$571.2$40.84$121.21$856.8
WHITESBURG ARHWHITESBURGKY7$341$204.6$45.5$114.34$139.05
TUG VALLEY ARHSOUTH WILLIAMSONKY11$1,159$695.4$27.85$114.34$1,043.1
PAINTSVILLE ARH HOSPITALPAINTSVILLEKY9$1,104$662.4$25.99$114.34$965.23
HIGHLANDS REGIONAL MEDICAL CENTERPRESTONSBURGKY10$341$204.6$52.78$114.34$188.66
SPRING VIEW HOSPITALLEBANONKY0$739.34$295.74

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.