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Office visit, established patient, 10-19 min

CPT 99212 · negotiated-rate distribution across hospitals in PA

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Hospitals
57
Min
$14.53
Median
$80.57
Max
$145.80
Range multiplier
10.0×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Aetna27270$2.01$72.60$360.73179.5×
Blue Cross Blue Shield25257$3.17$41.61$236.0074.4×
Cigna23105$3.64$83.60$286.3378.7×
UnitedHealthcare2590$5.28$51.96$355.3067.3×
Multiplan1084$51.28$120.90$397.107.7×
upmc health plan2469$13.41$44.00$182.2513.6×
intergroup1458$59.17$147.20$3,704.0062.6×
geisinger1747$9.02$48.91$280.0631.0×
First Health1242$77.66$161.70$281.313.6×
pa health & wellness2034$14.20$44.31$90.296.4×
amerihealth caritas2130$28.60$40.59$62.442.2×
private health care systems1326$71.99$216.00$276.003.8×
wirerope works424$36.56$86.18$232.416.4×
Medicaid224$16.00$54.12$107.406.7×
america's choice424$59.17$124.00$376.206.4×
Humana922$34.22$186.01$267.757.8×
upmc work partners2020$58.20$60.40$62.641.1×
health partners plans (jefferson health plan)1115$30.16$39.21$60.322.0×
keystone first514$49.20$63.59$167.403.4×
preferred healthcare system612$120.90$172.50$172.501.4×
health payors organization310$148.75$158.10$401.202.7×
prime health services310$9.90$16.95$144.0014.5×
Oscar Health310$5.61$9.61$81.6014.5×
three rivers provider network39$66.23$139.50$376.205.7×
innovage28$8.25$14.13$120.0014.5×
fidelis28$131.25$139.50$354.002.7×
occunet28$11.55$19.78$168.0014.5×
selectcare48$148.80$186.30$218.401.5×
ibc26$36.38$36.38$36.381.0×
health coalition partners46$148.80$156.60$220.501.5×
health partners plans36$39.67$39.67$39.671.0×
jup health partners chip15$26.00$39.39$60.002.3×
jup pa health_wellness15$20.80$38.03$52.002.5×
abington pro ibc14$29.08$32.77$39.131.3×
national provider network24$159.90$218.55$277.201.7×
galaxy health plan14$96.80$122.00$147.201.5×
qualcare14$20.46$159.03$297.6014.5×
pennsylvania health and wellness33$58.05$58.05$58.051.0×
gateway health plan33$40.12$40.12$48.001.2×
univera13$34.65$76.23$101.642.9×
jup geisinger commercial13$36.63$41.05$48.321.3×
Anthem BCBS13$107.42$122.53$143.641.3×
independent health12$151.40$156.44$161.471.1×
intergroup service corp12$88.50$94.88$101.251.1×
prime net12$258.30$258.30$258.301.0×
american healthcare group11$156.00$156.00$156.001.0×
health plan of upper ohio valley11$96.56$96.56$96.561.0×
pa health and wellness inc11$48.00$48.00$48.001.0×
jab health partners11$39.67$39.67$39.671.0×
jup community behavioral health11$42.93$42.93$42.931.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Upmc HamotEriePA14$231.00$138.60$28.60$92.40$184.80
Upmc East HospitalMonroevillePA13$231.00$138.60$28.60$90.09$215.79
Upmc JamesonNew CastlePA12$315.00$189.00$15.42$86.10$277.20
Upmc PassavantPittsburghPA14$209.00$125.40$28.60$83.60$205.79
Upmc St MargaretPittsburghPA12$273.00$163.80$28.60$80.57$232.05
Thomas Jefferson Univ. HospitalPhiladelphiaPA5$130.00$36.38$79.59$167.40
Upmc Mercy HospitalPittsburghPA16$195.00$117.00$28.60$78.43$175.50
WellsboroWellsboroPA14$418.00$250.80$11.84$62.05$397.10
Upmc Childrens Hospital Of PghPittsburghPA12$345.00$207.00$20.00$58.20$276.00
The Childrens Home Of PittsburghPittsburghPA12$345.00$207.00$20.00$58.20$276.00
Altoona Regional Health SystemAltoonaPA12$345.00$207.00$20.00$58.20$276.00
Upmc Magee-Womens HospitalPittsburghPA12$345.00$207.00$20.00$58.20$276.00
Charles Cole Memorial HospitalCoudersportPA14$184.00$110.40$27.30$56.12$168.00
American Oncologic HospialPhiladelphiaPA10$480.00$4.17$54.79$297.60
Curahealth Heritage ValleyBeaverPA9$135.00$36.45$33.80$53.48$118.00
Aria HealthPhiladelphiaPA12$327.00$16.00$42.25$103.37
Upmc Northwest HospitalSenecaPA13$243.00$145.80$28.60$145.80$3,704.00
Temple University HospitalPhiladelphiaPA16$480.00$2.01$14.78$168.00
Jeanes HospitalPhiladelphiaPA14$480.00$2.01$14.53$179.52
Upmc - Presbyterian ShadysidePittsburghPA5$472.00$283.20$39.83$131.25$401.20
Upmc ShadysidePittsburghPA19$186.00$111.60$28.60$130.20$234.70
Upmc Horizon HospitalGreenvillePA17$315.00$189.00$27.30$123.48$267.75
Lock Haven HospitalLock HavenPA15$418.00$250.80$28.60$120.90$376.20
Williamsport Hospital & Medical CtrWilliamsportPA15$418.00$250.80$28.60$120.90$376.20
Divine Providence HospitalWilliamsportPA15$418.00$250.80$28.60$120.90$376.20
Upmc Bedford Memorial HospitalEverettPA17$174.00$104.40$27.30$109.36$156.60
Upmc MckeesportMckeesportPA13$270.00$162.00$28.60$105.48$229.50
John Heinz Instit. Of Rehab MedicineWilkes-BarrePA0$106.00
Penn State Hershey Rehabilitation LlHummelstownPA0$115.00$29.91
St Christophers Hospital For ChildrPhiladelphiaPA0$207.00$103.50
Pennsylvania Psychiatric InstituteHarrisburgPA0$216.00$37.07
Holy Spirit HospitalCamp HillPA0$216.00$51.60
Chestnut Hill HospitalPhiladelphiaPA0$216.00$54.00
Uniontown HospitalUniontownPA0$376.00$188.00
Reading Hospital And Medical CenterReadingPA0$216.00$151.20
Clarion HospitalClarionPA0$159.00$89.04
St. Joseph Medical CenterReadingPA0$115.00$29.91
Hospital Of The Univ Of PennaPhiladelphiaPA0$305.00$305.00
Windber Hospital Inc.WindberPA0$110.48$93.91
Pottstown Memorial Medical CenterPottstownPA0$216.00$54.00
Wayne Memorial HospitalHonesdalePA0$308.00$215.60
Phoenixville HospitalPhoenixvillePA0$216.00$54.00
Miners HospitalHastingsPA0$136.00$54.40
Westmoreland Regional HospitalGreensburgPA0$270.00$162.00
Butler Memorial HospitalButlerPA0$171.00$119.70
The Chester County HospitalWest ChesterPA0$342.00$342.00
Doylestown HospitalDoylestownPA0$359.00$359.00
Frick HospitalMount PleasantPA0$270.00$162.00
Latrobe Area HospitalLatrobePA0$270.00$162.00
Presbyterian Medical CenterPhiladelphiaPA0$557.00$557.00
Pennsylvania Hospital Of UphsPhiladelphiaPA0$305.00$305.00
Milton S. Hershey Medical CenterHersheyPA0$115.00$38.10
Physicians Care Surgical HospitalRoyersfordPA0$164.00
Meyersdale Community HospitalMeyersdalePA0$141.00$56.40
Miners HospitalHastingsPA0$136.00$54.40
Lifecare Hospitals Of Chester CountyWest ChesterPA0$342.00$342.00
Allied Services Rehab HospitalScrantonPA0$106.00

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.