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Kentucky 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 $79 · 10th–90th $55–$1170%10%20%10th90th$79Professionalmedian $112 · 10th–90th $68–$2510%5%10%10th90th$112$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
$53.70 / $74.13 / $97.72
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$109.65 / $109.65 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $109.65 / $251.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$72.44 / $120.23 / $263.03
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $109.65 / $147.91
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$87.10 / $109.65 / $144.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $91.20 / $125.89
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $89.13 / $125.89
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $120.23 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $112.20 / $524.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $60.26 / $114.82
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $93.33 / $151.36
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $134.90 / $213.80