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Nationwide rates for HCPCS 99202

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. When using total time on the date of the encounter for code selection, 15 minutes must be met or exceeded.

Facilitymedian $74 · 10th–90th $42–$2140%20%10th90th$74Professionalmedian $79 · 10th–90th $43–$1820%20%10th90th$79$0.0$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$38.90 / $72.44 / $229.09
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$64.57 / $154.88 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $74.13 / $169.82
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$52.48 / $93.33 / $204.17
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $66.07 / $72.44
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $69.18 / $117.49
BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $141.25 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $75.86 / $144.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$38.90 / $63.10 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $75.86 / $151.36
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $85.11 / $144.54

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