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Pennsylvania rates for HCPCS 98968

Telephone assessment and management service provided by a nonphysician qualified health care professional to an established patient, parent, or guardian not originating from a related assessment and management service provided within the previous 7 days nor leading to an assessment and management service or procedure within the next 24 hours or soonest available appointment; 21-30 minutes of medical discussion

Facilitymedian $32 · 10th–90th $30–$450%20%40%10th90th$32Professionalmedian $37 · 10th–90th $30–$720%20%10th90th$37$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $32.36 / $33.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $36.31 / $70.79
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $27.54 / $51.29
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $35.48 / $61.66
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $52.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $43.65 / $79.43
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $64.57
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $51.29 / $70.79
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $44.67 / $64.57
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $38.90 / $38.90
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $32.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $38.02 / $72.44
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $30.90 / $38.02
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $64.57 / $85.11
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $33.11 / $44.67
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$19.95 / $31.62 / $44.67
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$28.84 / $31.62 / $36.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $39.81 / $70.79