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Nationwide rates for HCPCS 99203

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and low level of medical decision making. When using total time on the date of the encounter for code selection, 30 minutes must be met or exceeded.

Facilitymedian $115 · 10th–90th $66$2690%10%10th90th$115Professionalmedian $117 · 10th–90th $68$2750%10%20%10th90th$117$0.1$1.0$10.0$100.0$1.0K$10.0K

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
$61.66 / $109.65 / $269.15
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$93.33 / $229.09 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $112.20 / $275.42
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$72.44 / $125.89 / $288.40
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $97.72 / $109.65
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $102.33 / $177.83
BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $144.54 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $117.49 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $93.33 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $107.15 / $245.47
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $109.65 / $177.83