go back

Illinois 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 $120 · 10th–90th $59–$2240%5%10%10th90th$120Professionalmedian $117 · 10th–90th $69–$2630%5%10%10th90th$117$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$53.70 / $112.20 / $218.78
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$97.72 / $173.78 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $112.20 / $263.03
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$72.44 / $123.03 / $275.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $109.65 / $158.49
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $112.20 / $154.88
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $181.97 / $309.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $102.33 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $134.90 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $120.23 / $199.53
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $141.25 / $263.03
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
$87.10 / $102.33 / $138.04
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $165.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $109.65 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $213.80
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $120.23 / $204.17