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Office visit, new patient, 60-74 min

CPT 99205 · negotiated-rate distribution across hospitals in OH

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Hospitals
12
Min
$93.5
Median
$162.9
Max
$171.99
Range multiplier
1.8×

By payer (40 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
UnitedHealthcare535$38.15$100.71$286.37.5×
Medicare232$79.65$93.88$162.322.0×
Aetna528$38.15$145.95$194.595.1×
Anthem BCBS325$37.4$137.35$176.614.7×
transplants-case rates [5750]117$61.95$79.65$145.952.4×
healthsmart214$60.5$150.45$208.853.5×
Humana514$37.78$103.12$233.426.2×
First Health412$85.8$145.85$192.632.2×
Cigna310$87.96$153.99$183.572.1×
the health plan310$37.4$148.61$171.994.6×
ohio health choice310$77$147.7$195.582.5×
medical mutual19$37.4$80.3$154.034.1×
aultcare19$37.4$69.03$101.282.7×
Medicaid29$52$115.66$1773.4×
medical mutual of ohio29$100.74$128.94$185.161.8×
summacare19$37.4$93.5$179.354.8×
Molina37$37.4$100.74$202.625.4×
Blue Cross Blue Shield27$160.24$168.67$428.682.7×
ohio preferred network16$82.5$141.6$179.352.2×
commercial-contracted [8000]15$108.59$132.75$1771.6×
ohio ppo connect24$171.99$171.99$171.991.0×
Multiplan24$233.42$233.42$233.421.0×
buckeye13$38.15$61.39$73.181.9×
CareSource13$38.15$61.39$73.181.9×
priority health13$109.54$200.8$216.442.0×
integrated health plan12$233.42$233.42$233.421.0×
buckeye community health plan22$100.74$111.77$122.81.2×
medical mutual of ohio supermed12$185.16$185.16$185.161.0×
sidecar health22$277.64$307.67$337.71.2×
care source22$102.75$114.01$125.261.2×
workers compensation12$64.45$95.9$127.352.0×
medigold22$100.74$111.77$122.81.2×
three rivers network12$233.42$233.42$233.421.0×
care source just4me22$181.33$201.19$221.041.2×
bcccnp11$115$115$1151.0×
u of m health plan11$183.01$183.01$183.011.0×
safe response program11$275$275$2751.0×
mclaren commercial ins11$168$168$1681.0×
gateway health11$125.26$125.26$125.261.0×
hap - hmo11$177$177$1771.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
ADAMS COUNTY REGIONAL MEDICAL CENTERSEAMANOH9$177$106.2$52$93.88$177
TWIN CITY HOSPITALDENNISONOH16$211$104.66$37.4$93.5$192.01
ADENA REGIONAL MEDICAL CENTERCHILLICOTHEOH21$245.7$122.85$87.96$171.99$337.7
ST. LUKES HOSPITALMAUMEEOH13$409$204.5$64.45$163.91$428.68
FAYETTE COUNTY MEMORIAL HOSPWASHINGTON COURT HOUSEOH18$245.7$122.85$83.54$162.9$277.64
BARNESVILLE HOSPITALBARNESVILLEOH0$478$239
WILSON MEMORIAL HOSPITALSIDNEYOH0$455.7$227.85
SUMMA REHAB HOSPITALAKRONOH0$655
WAYNE HOSPITAL COMPANYGREENVILLEOH0$420$315
TRUMBULL MEMORIAL HOSPITALWARRENOH0$500$400
HENRY COUNTY HOSPITAL (CAH)NAPOLEONOH0$215$161.25
HARRISON COMMUNITY HOSPITALCADIZOH0$439$219.5

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.