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Massachusetts 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 $107 · 10th–90th $55–$2000%10%10th90th$107Professionalmedian $123 · 10th–90th $69–$3090%5%10%10th90th$123$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
$74.13 / $120.23 / $165.96
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$194.98 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $114.82 / $309.03
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$74.13 / $128.82 / $323.59
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $275.42 / $512.86
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $128.82 / $346.74
AllWays Health Partners
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$44.67 / $70.79 / $138.04
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $134.90 / $234.42
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $158.49 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $194.98 / $263.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $123.03 / $234.42
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $63.10 / $112.20
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $102.33 / $194.98
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $154.88 / $295.12
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $125.89 / $323.59
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $177.83 / $363.08
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $275.42 / $512.86
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $128.82 / $346.74
Mass General Brigham
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$44.67 / $70.79 / $138.04
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $66.07 / $66.07
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $114.82 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $93.33 / $131.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $131.83 / $288.40
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $131.83 / $186.21