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Office visit, new patient, 60-74 min

CPT 99205 · negotiated-rate distribution across hospitals in PA

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Hospitals
53
Min
$124.74
Median
$188.00
Max
$526.20
Range multiplier
4.2×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Aetna27228$23.76$234.88$848.3335.7×
Blue Cross Blue Shield26189$26.40$174.31$756.2028.6×
Cigna2292$27.72$237.20$673.3624.3×
UnitedHealthcare2579$28.25$150.45$835.5529.6×
Multiplan1078$102.96$443.04$1,028.5810.0×
upmc health plan2466$26.93$129.29$613.9022.8×
intergroup1456$118.80$492.00$3,704.0031.2×
geisinger1742$41.70$163.37$701.6016.8×
First Health1242$77.66$506.25$774.2010.0×
pa health & wellness2033$28.51$200.31$265.209.3×
amerihealth caritas2130$46.83$183.49$251.705.4×
private health care systems1326$307.49$533.70$1,028.583.3×
wirerope works422$73.39$271.88$546.557.4×
america's choice422$118.80$440.10$884.707.4×
Humana922$136.31$701.60$1,028.587.5×
upmc work partners2020$236.04$252.73$280.881.2×
Medicaid218$60.00$118.59$234.363.9×
health partners plans (jefferson health plan)1115$45.24$177.25$177.253.9×
preferred healthcare system612$286.50$286.50$474.401.7×
keystone first512$73.80$267.58$327.944.4×
three rivers provider network39$139.50$282.89$884.706.3×
health payors organization38$513.40$539.75$716.551.4×
selectcare48$483.20$578.85$828.001.7×
health coalition partners46$483.20$533.70$631.441.3×
fidelis26$453.00$453.00$632.251.4×
health partners plans36$97.08$97.08$97.081.0×
ibc26$187.26$187.26$187.261.0×
prime health services35$132.00$267.30$267.302.0×
Oscar Health35$74.80$151.47$151.472.0×
abington pro ibc14$163.25$183.49$203.811.2×
galaxy health plan14$385.60$543.60$701.601.8×
innovage24$110.00$166.38$222.752.0×
national provider network24$515.78$643.77$771.761.5×
occunet24$154.00$232.93$311.852.0×
pennsylvania health and wellness33$262.41$262.41$262.411.0×
Anthem BCBS13$299.06$341.15$399.911.3×
univera13$90.15$198.33$264.442.9×
jup health partners chip13$60.00$117.54$158.372.6×
gateway health plan33$72.00$207.55$207.552.9×
Medicare12$153.74$168.13$182.531.2×
pa health_wellness chc22$78.00$78.00$78.001.0×
jup community behavioral health12$171.72$179.04$186.361.1×
prime net12$719.14$719.14$719.141.0×
qualcare12$552.42$552.42$552.421.0×
independent health12$206.88$213.75$220.611.1×
jup pa health_wellness12$78.00$115.40$152.802.0×
bravo11$220.15$220.15$220.151.0×
magellan health11$156.78$156.78$156.781.0×
health plan of upper ohio valley11$510.97$510.97$510.971.0×
pa health and wellness inc11$72.00$72.00$72.001.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Upmc Northwest HospitalSenecaPA13$877.00$526.20$36.08$526.20$3,704.00
Upmc ShadysidePittsburghPA19$604.00$362.40$36.08$422.80$756.20
Upmc MckeesportMckeesportPA13$1,035.00$621.00$36.08$398.48$879.75
Upmc Bedford Memorial HospitalEverettPA17$593.00$355.80$36.08$372.70$533.70
Upmc - Presbyterian ShadysidePittsburghPA5$843.00$505.80$147.82$362.40$716.55
Upmc Horizon HospitalGreenvillePA17$877.00$526.20$36.08$343.78$745.45
Upmc East HospitalMonroevillePA13$860.00$516.00$36.08$335.40$695.27
Upmc PassavantPittsburghPA14$1,106.00$663.60$36.08$335.10$1,028.58
Charles Cole Memorial HospitalCoudersportPA14$877.00$526.20$65.78$265.20$719.14
Upmc St MargaretPittsburghPA12$780.00$468.00$36.08$260.91$695.27
Upmc Mercy HospitalPittsburghPA16$629.00$377.40$36.08$257.69$566.10
Upmc HamotEriePA14$601.00$360.60$63.91$230.51$527.06
Upmc JamesonNew CastlePA12$877.00$526.20$29.68$226.22$771.76
American Oncologic HospialPhiladelphiaPA10$891.00$97.08$188.00$552.42
Curahealth Heritage ValleyBeaverPA7$400.00$108.00$72.00$177.60$400.00
WellsboroWellsboroPA14$983.00$589.80$23.76$177.25$933.85
Altoona Regional Health SystemAltoonaPA12$573.00$343.80$30.00$174.31$458.40
Upmc Magee-Womens HospitalPittsburghPA12$573.00$343.80$30.00$174.31$458.40
Upmc Childrens Hospital Of PghPittsburghPA12$573.00$343.80$30.00$174.31$458.40
The Childrens Home Of PittsburghPittsburghPA12$573.00$343.80$30.00$174.31$458.40
Thomas Jefferson Univ. HospitalPhiladelphiaPA5$385.00$78.00$167.40$327.94
Aria HealthPhiladelphiaPA14$335.00$282.51$60.00$158.69$453.36
Lock Haven HospitalLock HavenPA15$983.00$589.80$41.85$157.80$884.70
Divine Providence HospitalWilliamsportPA15$983.00$589.80$41.85$157.80$884.70
Williamsport Hospital & Medical CtrWilliamsportPA15$983.00$589.80$41.85$157.80$884.70
Temple University HospitalPhiladelphiaPA16$891.00$26.84$137.35$311.85
Jeanes HospitalPhiladelphiaPA14$891.00$26.84$124.74$333.23
Pennsylvania Psychiatric InstituteHarrisburgPA0$632.00$108.45
Holy Spirit HospitalCamp HillPA0$632.00$150.98
Chestnut Hill HospitalPhiladelphiaPA0$603.00$150.75
Uniontown HospitalUniontownPA0$930.00$465.00
Reading Hospital And Medical CenterReadingPA0$603.00$422.10
Clarion HospitalClarionPA0
St. Joseph Medical CenterReadingPA0$115.00$29.91
Windber Hospital Inc.WindberPA0$390.00$331.50
Pottstown Memorial Medical CenterPottstownPA0$603.00$150.75
Wayne Memorial HospitalHonesdalePA0$318.00$222.60
Phoenixville HospitalPhoenixvillePA0$603.00$150.75
Miners HospitalHastingsPA0$453.00$181.20
Westmoreland Regional HospitalGreensburgPA0$450.00$270.00
Butler Memorial HospitalButlerPA0$426.00$298.20
The Chester County HospitalWest ChesterPA0$342.00$342.00
Doylestown HospitalDoylestownPA0$359.00$359.00
Frick HospitalMount PleasantPA0$434.00$260.40
Latrobe Area HospitalLatrobePA0$434.00$260.40
Presbyterian Medical CenterPhiladelphiaPA0$1,232.00$1,232.00
Physicians Care Surgical HospitalRoyersfordPA0$490.00
Meyersdale Community HospitalMeyersdalePA0$472.00$188.80
Miners HospitalHastingsPA0$453.00$181.20
Lifecare Hospitals Of Chester CountyWest ChesterPA0$342.00$342.00
Allied Services Rehab HospitalScrantonPA0$546.00
John Heinz Instit. Of Rehab MedicineWilkes-BarrePA0$546.00
Penn State Hershey Rehabilitation LlHummelstownPA0$115.00$29.91

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.