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Ohio 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 $49 · 10th–90th $35–$890%20%10th90th$49Professionalmedian $79 · 10th–90th $43–$1740%5%10%10th90th$79$1.0$5.0$20.0$100.0$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
$36.31 / $48.98 / $95.50
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$10.47 / $48.98 / $50.12
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $74.13 / $169.82
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$51.29 / $91.20 / $199.53
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $70.79 / $93.33
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$53.70 / $69.18 / $87.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $69.18 / $109.65
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $75.86 / $114.82
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $51.29 / $72.44
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $72.44 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $120.23 / $165.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $72.44 / $128.82
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $120.23 / $181.97
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $74.13 / $123.03
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $33.11 / $63.10
Optum
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $83.18 / $123.03
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $70.79 / $104.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $64.57 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $69.18 / $120.23
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $79.43 / $114.82