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Michigan 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 $93 · 10th–90th $65–$1350%10%10th90th$93Professionalmedian $117 · 10th–90th $69–$2820%5%10%10th90th$117$5.0$10.0$20.0$50.0$100.0$200.0$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
$64.57 / $91.20 / $125.89
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$93.33 / $213.80 / $537.03
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
$75.86 / $131.83 / $295.12
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $109.65 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$87.10 / $112.20 / $158.49
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $134.90
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $123.03 / $158.49
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $104.71 / $141.25
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $138.04 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $107.15 / $223.87
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $95.50 / $125.89
Health Alliance Plan
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$93.33 / $93.33 / $537.03
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $104.71 / $229.09
Health Alliance Plan
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$74.13 / $131.83 / $288.40
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $147.91
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $104.71 / $154.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $87.10 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $104.71 / $204.17
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $134.90 / $213.80