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Maine 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 $141 · 10th–90th $68–$3390%10%20%10th90th$141Professionalmedian $107 · 10th–90th $66–$2450%10%20%10th90th$107$1.0$5.0$20.0$100.0$500.0$2.0K$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
$66.07 / $134.90 / $331.13
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$67.61 / $162.18 / $338.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $102.33 / $234.42
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$74.13 / $112.20 / $275.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $123.03 / $194.98
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $81.28 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $112.20 / $218.78
Community Health Options
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $223.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $151.36 / $288.40
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $93.33 / $10,000.00
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $97.72 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $134.90 / $234.42
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $131.83 / $218.78