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Texas 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 $78 · 10th–90th $41–$2140%5%10%10th90th$78Professionalmedian $68 · 10th–90th $40–$1510%10%10th90th$68$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
$38.90 / $114.82 / $269.15
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$107.15 / $169.82 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $69.18 / $154.88
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$48.98 / $87.10 / $194.98
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $72.44 / $93.33
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$50.12 / $69.18 / $81.28
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$31.62 / $79.43 / $229.09
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $51.29 / $70.79
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$47.86 / $54.95 / $169.82
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $72.44 / $114.82
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $43.65 / $72.44
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $169.82 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $74.13 / $123.03
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $302.00 / $302.00
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $120.23 / $457.09
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $74.13 / $125.89
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$107.15 / $169.82 / $316.23
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.90 / $66.07 / $112.20
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$48.98 / $89.13 / $186.21
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $33.11 / $47.86
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $104.71 / $302.00
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $95.50 / $269.15
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $74.13 / $125.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $75.86 / $131.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $63.10 / $87.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $67.61 / $107.15
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $79.43 / $95.50
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $75.86 / $81.28