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Office visit, established patient, 20-29 minutes
CPT 99213 · negotiated-rate distribution across hospitals in WV
Hospitals
18
Min
$65.13
Median
$271.41
Max
$271.41
Range multiplier
4.2×
By payer (33 payers with published rates)
| Payer | Hosp. | Rates | Min | Median | Max | Range× |
|---|---|---|---|---|---|---|
| Aetna | 2 | 10 | $56.25 | $184.69 | $494.00 | 8.8× |
| UnitedHealthcare | 2 | 8 | $58.46 | $260.78 | $419.50 | 7.2× |
| Cigna | 1 | 5 | $159.56 | $286.45 | $351.14 | 2.2× |
| Blue Cross Blue Shield | 1 | 4 | $123.82 | $148.89 | $166.89 | 1.3× |
| harvard pilgrim [10701] | 1 | 3 | $118.02 | $118.02 | $118.02 | 1.0× |
| fallon carelon hlth [28] | 1 | 2 | $403.00 | $448.50 | $494.00 | 1.2× |
| fallon mcaid carelon hlth [29] | 1 | 2 | $403.00 | $448.50 | $494.00 | 1.2× |
| fallon mcr [10105] | 1 | 2 | $167.53 | $168.57 | $169.61 | 1.0× |
| fallon mcr supp [20202] | 1 | 2 | $167.53 | $168.57 | $169.61 | 1.0× |
| First Health | 1 | 2 | $302.25 | $336.38 | $370.50 | 1.2× |
| grants [20507] | 1 | 2 | $403.00 | $448.50 | $494.00 | 1.2× |
| hp optum bh [32] | 1 | 2 | $403.00 | $448.50 | $494.00 | 1.2× |
| CHAMPVA | 1 | 2 | $64.90 | $108.97 | $153.04 | 2.4× |
| institution [10406] | 1 | 2 | $159.56 | $160.55 | $161.53 | 1.0× |
| masshealth mcd mbhp [38] | 1 | 2 | $403.00 | $448.50 | $494.00 | 1.2× |
| Medicaid | 1 | 2 | $209.56 | $233.22 | $256.88 | 1.2× |
| mgb mcr [10124] | 1 | 2 | $159.56 | $160.55 | $161.53 | 1.0× |
| the health plan | 1 | 2 | $65.14 | $65.14 | $65.14 | 1.0× |
| the health plan hmo | 1 | 2 | $62.16 | $126.42 | $190.68 | 3.1× |
| tufts [11201] | 1 | 2 | $286.45 | $318.80 | $351.14 | 1.2× |
| commonwealth care alliance [10103] | 1 | 2 | $167.53 | $168.57 | $169.61 | 1.0× |
| tufts connectorcare [10507] | 1 | 2 | $271.41 | $273.09 | $274.77 | 1.0× |
| connecticare [11105] | 1 | 2 | $403.00 | $448.50 | $494.00 | 1.2× |
| umr | 1 | 2 | $58.46 | $118.90 | $179.33 | 3.1× |
| evernorth behavioral health [27] | 1 | 2 | $322.40 | $358.80 | $395.20 | 1.2× |
| wellsense mcaid carelon hlth [21] | 1 | 2 | $403.00 | $448.50 | $494.00 | 1.2× |
| workers compensation [20501] | 1 | 1 | $65.91 | $65.91 | $65.91 | 1.0× |
| hne [11108] | 1 | 1 | $262.27 | $262.27 | $262.27 | 1.0× |
| hsno/free care [10801] | 1 | 1 | $680.81 | $680.81 | $680.81 | 1.0× |
| senior whole health [10110] | 1 | 1 | $172.84 | $172.84 | $172.84 | 1.0× |
| tufts mcr [10112] | 1 | 1 | $169.61 | $169.61 | $169.61 | 1.0× |
| tufts us family [11203] | 1 | 1 | $161.53 | $161.53 | $161.53 | 1.0× |
| wellpoint [11112] | 1 | 1 | $42.29 | $42.29 | $42.29 | 1.0× |
By hospital (top 200 by negotiated median, descending)
| Hospital | City | ST | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| Beckley Arh | Beckley | WV | 5 | $227.00 | $136.20 | $56.25 | $65.13 | $199.76 |
| Webster County Memorial Hospital | Webster Springs | WV | 30 | $494.00 | $494.00 | $42.29 | $271.41 | $680.81 |
| Reynolds Memorial Hospital | Glen Dale | WV | 0 | $216.00 | $108.00 | — | — | — |
| Jackson General Hospital | Ripley | WV | 0 | $144.00 | $72.00 | — | — | — |
| Princeton Community Hospital | Princeton | WV | 0 | $224.00 | $112.00 | — | — | — |
| Wheeling Hospital | Wheeling | WV | 0 | $144.00 | $72.00 | — | — | — |
| Camden-Clark Memorial Hospital | Parkersburg | WV | 0 | $126.00 | $63.00 | — | — | — |
| Wetzel County Hospital | New Martinsville | WV | 0 | $373.00 | $186.50 | — | — | — |
| Summersville Regional Med Center | Summersville | WV | 0 | $144.00 | $72.00 | — | — | — |
| Braxton County Memorial Hospital | Gassaway | WV | 0 | $144.00 | $72.00 | — | — | — |
| Potomac Valley Hospital | Keyser | WV | 0 | $290.00 | $145.00 | — | — | — |
| Grant Memorial Hospital | Petersburg | WV | 0 | $210.00 | $168.00 | — | — | — |
| Jefferson Memorial Hospital | Ranson | WV | 0 | $144.00 | $72.00 | — | — | — |
| Jackson General Hospital | Ripley | WV | 0 | $144.00 | $72.00 | — | — | — |
| St. Josephs Hospital Of Buckhannon | Buckhannon | WV | 0 | $144.00 | $72.00 | — | — | — |
| West Virginia University Hospitals | Morgantown | WV | 0 | $135.00 | $67.50 | — | — | — |
| Summersville Regional Med Center | Summersville | WV | 0 | $144.00 | $72.00 | — | — | — |
| City Hospital Inc. | Martinsburg | WV | 0 | $187.00 | $93.50 | — | — | — |
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.