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Office visit, new patient, 45-59 min

CPT 99204 · negotiated-rate distribution across hospitals in OH

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Hospitals
12
Min
$58.34
Median
$122.25
Max
$153.62
Range multiplier
2.6×

By payer (41 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare536$34.68$73.79$252.707.3×
Medicare232$49.50$58.34$118.342.4×
Aetna529$34.68$104.50$173.805.0×
Anthem BCBS325$34.00$121.98$145.504.3×
transplants-case rates [5750]117$38.50$49.50$90.712.4×
healthsmart214$55.00$129.20$186.533.4×
Humana514$34.34$84.49$208.486.1×
First Health412$78.00$104.60$172.052.2×
ohio health choice310$70.00$110.60$174.682.5×
the health plan310$34.00$118.74$153.624.5×
Cigna310$78.56$134.04$151.201.9×
medical mutual of ohio29$89.97$128.94$165.381.8×
Medicaid29$52.00$84.99$110.002.1×
summacare19$34.00$85.00$134.304.0×
medical mutual19$34.00$73.00$115.343.4×
aultcare19$34.00$53.72$75.842.2×
Molina37$34.00$89.97$202.626.0×
Blue Cross Blue Shield27$95.95$101.00$353.693.7×
ohio preferred network16$75.00$116.25$134.301.8×
commercial-contracted [8000]15$67.49$82.50$110.001.6×
priority health14$101.61$127.00$191.041.9×
ohio ppo connect24$153.62$153.62$153.621.0×
Multiplan24$208.48$208.48$208.481.0×
CareSource13$34.68$52.72$54.801.6×
buckeye13$34.68$52.72$54.801.6×
workers compensation12$59.78$61.33$62.871.1×
integrated health plan12$208.48$208.48$208.481.0×
medical mutual of ohio supermed12$165.38$165.38$165.381.0×
medigold22$89.97$106.39$122.801.4×
care source just4me22$161.95$191.50$221.041.4×
sidecar health22$247.98$292.84$337.701.4×
care source22$91.77$108.52$125.261.4×
buckeye community health plan22$89.97$106.39$122.801.4×
three rivers network12$208.48$208.48$208.481.0×
mclaren commercial ins12$53.18$89.09$125.002.4×
cofinity group 15892 & 1589311$92.16$92.16$92.161.0×
u of m health plan11$133.42$133.42$133.421.0×
gateway health11$125.26$125.26$125.261.0×
safe response program11$250.00$250.00$250.001.0×
bcccnp11$115.00$115.00$115.001.0×
hap - hmo11$130.19$130.19$130.191.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Twin City HospitalDennisonOH16$158.00$78.37$34.00$85.00$143.78
Adams County Regional Medical CenterSeamanOH9$110.00$66.00$38.50$58.34$110.00
Adena Regional Medical CenterChillicotheOH21$219.45$109.73$78.56$153.62$337.70
Fayette County Memorial HospWashington Court HouseOH18$219.45$109.73$74.61$145.50$247.98
St. Lukes HospitalMaumeeOH14$361.00$180.50$53.18$122.25$353.69
Barnesville HospitalBarnesvilleOH0$352.00$176.00
Wilson Memorial HospitalSidneyOH0$354.90$177.45
Summa Rehab HospitalAkronOH0$510.00
Wayne Hospital CompanyGreenvilleOH0$432.00$324.00
Trumbull Memorial HospitalWarrenOH0$375.00$300.00
Henry County Hospital (Cah)NapoleonOH0$165.00$123.75
Harrison Community HospitalCadizOH0$352.00$176.00

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.