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Office visit, established patient, 20-29 minutes

CPT 99213 · negotiated-rate distribution across hospitals in PA

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Hospitals
57
Min
$53.87
Median
$103.80
Max
$287.12
Range multiplier
5.3×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Aetna28262$8.78$102.30$360.7341.1×
Blue Cross Blue Shield26249$13.82$80.13$355.0025.7×
Cigna24105$15.33$104.40$426.0027.8×
UnitedHealthcare2692$15.62$87.43$358.9023.0×
Multiplan1185$56.94$182.70$522.039.2×
upmc health plan2473$14.89$44.00$213.5014.3×
intergroup1458$65.70$182.70$3,704.0056.4×
geisinger1749$27.80$55.60$280.0610.1×
First Health1343$77.66$209.42$424.155.5×
pa health & wellness2038$15.77$59.65$92.235.8×
amerihealth caritas2134$31.22$54.64$87.532.8×
private health care systems1427$102.79$248.80$522.035.1×
america's choice424$65.70$158.40$376.205.7×
wirerope works424$40.59$99.53$232.415.7×
Medicaid322$17.60$62.31$107.676.1×
Humana922$45.25$257.13$306.006.8×
upmc work partners2020$82.05$86.46$89.451.1×
health partners plans (jefferson health plan)1119$30.16$52.78$60.322.0×
keystone first513$49.20$85.60$167.403.4×
preferred healthcare system612$159.90$192.00$192.001.2×
health payors organization310$209.10$211.50$603.502.9×
three rivers provider network39$94.57$139.50$376.204.0×
fidelis28$184.50$202.13$532.502.9×
selectcare48$181.80$220.80$244.801.3×
prime health services38$43.20$150.00$155.703.6×
Oscar Health38$24.48$85.00$88.233.6×
innovage26$36.00$125.00$129.753.6×
health partners plans36$39.67$39.67$39.671.0×
health coalition partners46$181.80$196.80$252.001.4×
ibc26$67.86$67.86$67.861.0×
abington pro ibc16$54.57$61.51$73.421.3×
occunet26$50.40$175.00$181.653.6×
qualcare25$310.00$321.78$358.901.2×
national provider network24$192.70$254.75$316.801.6×
jup health partners chip14$16.00$37.50$64.624.0×
galaxy health plan14$128.00$186.00$244.001.9×
gateway health plan33$48.00$74.08$74.081.5×
Anthem BCBS13$122.76$140.04$164.161.3×
jup pa health_wellness13$20.80$45.50$52.002.5×
pennsylvania health and wellness33$78.14$78.14$78.141.0×
univera13$39.15$86.13$114.842.9×
Medicare12$46.16$50.48$54.811.2×
jup geisinger commercial12$73.97$78.43$82.891.1×
jup community behavioral health12$85.86$89.52$93.181.1×
intergroup service corp12$103.50$120.75$138.001.3×
independent health12$151.40$156.44$161.471.1×
prime net12$295.20$295.20$295.201.0×
pa health and wellness inc11$48.00$48.00$48.001.0×
pa health_wellness chc11$78.00$78.00$78.001.0×
bravo11$82.25$82.25$82.251.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Upmc Mercy HospitalPittsburghPA16$235.00$141.00$36.08$97.80$211.50
Charles Cole Memorial HospitalCoudersportPA14$305.00$183.00$36.75$92.23$250.10
Upmc JamesonNew CastlePA12$360.00$216.00$17.84$86.10$316.80
WellsboroWellsboroPA14$418.00$250.80$13.14$83.60$397.10
Thomas Jefferson Univ. HospitalPhiladelphiaPA5$144.00$39.67$79.59$167.40
Temple University HospitalPhiladelphiaPA16$519.00$8.78$75.00$181.65
Curahealth Heritage ValleyBeaverPA9$184.00$49.68$40.00$72.85$138.00
Jeanes HospitalPhiladelphiaPA14$519.00$8.78$70.00$194.11
Aria HealthPhiladelphiaPA12$327.00$16.00$59.87$162.86
Altoona Regional Health SystemAltoonaPA12$384.00$230.40$20.00$53.87$307.20
Upmc Childrens Hospital Of PghPittsburghPA12$384.00$230.40$20.00$53.87$307.20
The Childrens Home Of PittsburghPittsburghPA12$384.00$230.40$20.00$53.87$307.20
Upmc Magee-Womens HospitalPittsburghPA12$384.00$230.40$20.00$53.87$307.20
The Childrens Hospital Of PhiladelpPhiladelphiaPA17$652.54$652.54$107.67$287.12$587.29
Upmc Northwest HospitalSenecaPA13$311.00$186.60$36.08$186.60$3,704.00
Upmc - Presbyterian ShadysidePittsburghPA5$710.00$426.00$53.29$184.50$603.50
Upmc ShadysidePittsburghPA19$246.00$147.60$36.08$172.20$302.38
Upmc Horizon HospitalGreenvillePA17$360.00$216.00$36.08$141.12$306.00
Upmc Bedford Memorial HospitalEverettPA17$202.00$121.20$36.08$126.96$181.80
Upmc MckeesportMckeesportPA13$306.00$183.60$36.08$122.40$260.10
Upmc East HospitalMonroevillePA13$311.00$186.60$36.08$121.29$278.02
Williamsport Hospital & Medical CtrWilliamsportPA15$418.00$250.80$38.50$120.90$376.20
Lock Haven HospitalLock HavenPA15$418.00$250.80$38.50$120.90$376.20
Divine Providence HospitalWilliamsportPA15$418.00$250.80$38.50$120.90$376.20
Upmc PassavantPittsburghPA14$299.00$179.40$36.08$119.60$278.07
Upmc HamotEriePA14$261.00$156.60$38.50$104.40$208.80
Upmc St MargaretPittsburghPA12$306.00$183.60$36.08$103.80$278.02
American Oncologic HospialPhiladelphiaPA10$519.00$39.67$103.50$321.78
St Christophers Hospital For ChildrPhiladelphiaPA0$218.00$109.00
Pennsylvania Psychiatric InstituteHarrisburgPA0$303.00$51.99
Holy Spirit HospitalCamp HillPA0$303.00$72.39
Chestnut Hill HospitalPhiladelphiaPA0$270.00$67.50
Uniontown HospitalUniontownPA0$575.00$287.50
Reading Hospital And Medical CenterReadingPA0$270.00$189.00
Clarion HospitalClarionPA0$225.00$126.00
St. Joseph Medical CenterReadingPA0$115.00$29.91
Hospital Of The Univ Of PennaPhiladelphiaPA0$366.00$366.00
Windber Hospital Inc.WindberPA0$155.00$131.75
Pottstown Memorial Medical CenterPottstownPA0$270.00$67.50
Wayne Memorial HospitalHonesdalePA0$184.00$128.80
Phoenixville HospitalPhoenixvillePA0$270.00$67.50
Miners HospitalHastingsPA0$167.00$66.80
Westmoreland Regional HospitalGreensburgPA0$280.00$168.00
Butler Memorial HospitalButlerPA0$225.00$157.50
The Chester County HospitalWest ChesterPA0$342.00$342.00
Doylestown HospitalDoylestownPA0$359.00$359.00
Frick HospitalMount PleasantPA0$280.00$168.00
Latrobe Area HospitalLatrobePA0$280.00$168.00
Presbyterian Medical CenterPhiladelphiaPA0$777.00$777.00
Pennsylvania Hospital Of UphsPhiladelphiaPA0$366.00$366.00
Physicians Care Surgical HospitalRoyersfordPA0$255.00
Meyersdale Community HospitalMeyersdalePA0$162.00$64.80
Miners HospitalHastingsPA0$167.00$66.80
Lifecare Hospitals Of Chester CountyWest ChesterPA0$342.00$342.00
Allied Services Rehab HospitalScrantonPA0$136.00
John Heinz Instit. Of Rehab MedicineWilkes-BarrePA0$136.00
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.