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Illinois 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 $35–$1860%5%10%10th90th$74Professionalmedian $79 · 10th–90th $44–$1740%5%10%10th90th$79$10.0$20.0$50.0$100.0$200.0$500.0

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
$34.67 / $72.44 / $177.83
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$70.79 / $154.88 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $75.86 / $169.82
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$50.12 / $91.20 / $190.55
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $70.79 / $100.00
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$54.95 / $70.79 / $93.33
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $165.96 / $213.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $63.10 / $81.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $134.90 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $77.62 / $131.83
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $91.20 / $173.78
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $81.28 / $95.50
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $107.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $69.18 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $79.43 / $134.90
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$58.88 / $79.43 / $173.78