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Initial hospital care, low complexity

CPT 99221 · negotiated-rate distribution across hospitals in PA

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Hospitals
14
Min
$85.40
Median
$105.39
Max
$153.75
Range multiplier
1.8×

By payer (21 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Aetna312$58.30$171.65$244.734.2×
Blue Cross Blue Shield312$56.83$184.65$415.107.3×
upmc health plan27$57.40$106.00$187.823.3×
ibc27$85.40$85.40$85.401.0×
UnitedHealthcare26$44.73$92.08$185.574.1×
Medicaid16$50.77$73.52$129.702.6×
abington pro ibc15$88.55$104.18$118.461.3×
Multiplan14$164.00$164.00$164.001.0×
jup health partners chip14$50.77$70.27$87.711.7×
Humana13$57.97$164.00$164.002.8×
pa health & wellness13$61.99$61.99$112.751.8×
geisinger13$112.75$153.75$164.001.5×
Medicare13$82.83$93.03$110.461.3×
amerihealth caritas13$57.40$58.84$58.841.0×
jup geisinger commercial13$149.08$167.05$196.661.3×
intergroup service corp12$79.50$128.25$177.002.2×
galaxy health plan12$164.00$164.00$164.001.0×
intergroup12$164.00$164.00$164.001.0×
jup pa health_wellness11$84.57$84.57$84.571.0×
Cigna11$60.27$60.27$60.271.0×
upmc work partners11$151.43$151.43$151.431.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Aria HealthPhiladelphiaPA10$175.00$88.84$50.77$96.01$244.73
Thomas Jefferson Univ. HospitalPhiladelphiaPA1$85.40$85.40$85.40
Charles Cole Memorial HospitalCoudersportPA12$205.00$123.00$56.83$153.75$415.10
Curahealth Heritage ValleyBeaverPA5$236.00$63.72$44.73$105.39$236.00
Windber Hospital Inc.WindberPA0$157.00$133.45
Pottstown Memorial Medical CenterPottstownPA0$312.00$78.00
Phoenixville HospitalPhoenixvillePA0$312.00$78.00
Butler Memorial HospitalButlerPA0
Physicians Care Surgical HospitalRoyersfordPA0$50.00
Holy Spirit HospitalCamp HillPA0$236.00$56.38
Haven Behavioral Svcs Of Reading LlcReadingPA0$205.00
Chestnut Hill HospitalPhiladelphiaPA0$312.00$78.00
Reading Hospital And Medical CenterReadingPA0$312.00$218.40
Clarion HospitalClarionPA0

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.