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California 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 $72 · 10th–90th $48–$2000%10%20%10th90th$72Professionalmedian $87 · 10th–90th $51–$2450%10%10th90th$87$1.0$5.0$20.0$100.0$500.0$2.0K

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
$57.54 / $97.72 / $229.09
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$162.18 / $162.18 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $85.11 / $239.88
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$58.88 / $93.33 / $257.04
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $72.44 / $104.71
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$56.23 / $70.79 / $120.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $66.07 / $72.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $77.62 / $134.90
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $83.18 / $89.13
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $100.00 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $151.36 / $229.09
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $79.43 / $141.25
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $50.12 / $112.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $74.13 / $131.83
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $457.09 / $457.09
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $44.67 / $102.33
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $85.11 / $131.83
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$42.66 / $72.44 / $120.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $83.18 / $154.88
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $75.86 / $199.53
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $42.66 / $85.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $63.10 / $93.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$42.66 / $69.18 / $128.82
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $85.11 / $109.65