go back

Wisconsin 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 $41–$2140%5%10%10th90th$74Professionalmedian $87 · 10th–90th $42–$2140%5%10th90th$87$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
$40.74 / $104.71 / $288.40
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$173.78 / $288.40 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $72.44 / $204.17
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$51.29 / $109.65 / $229.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $89.13 / $165.96
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $57.54 / $83.18
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $85.11 / $158.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $223.87 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $109.65 / $208.93
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $61.66 / $117.49
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $120.23 / $190.55
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$40.74 / $63.10 / $134.90
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $141.25 / $457.09
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$125.89 / $194.98 / $234.42
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $97.72
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $100.00 / $186.21
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $117.49 / $186.21
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$87.10 / $87.10 / $302.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $109.65 / $457.09
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $57.54 / $85.11
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $97.72 / $147.91
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$33.88 / $50.12 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $144.54 / $239.88
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $79.43 / $91.20