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Montana 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 $138 · 10th–90th $81–$2000%10%10th90th$138Professionalmedian $123 · 10th–90th $68–$2880%5%10th90th$123$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
$104.71 / $138.04 / $165.96
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $120.23 / $288.40
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$66.07 / $125.89 / $288.40
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $151.36 / $177.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $128.82 / $177.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $114.82 / $218.78
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $154.88 / $199.53
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $154.88 / $199.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $114.82 / $208.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $158.49 / $295.12
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $128.82 / $186.21
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$97.72 / $141.25 / $213.80