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New Jersey 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 $83 · 10th–90th $51–$2630%10%10th90th$83Professionalmedian $110 · 10th–90th $65–$2510%5%10%10th90th$110$10.0$50.0$200.0$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
$51.29 / $81.28 / $234.42
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $104.71 / $245.47
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$69.18 / $117.49 / $275.42
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $109.65 / $158.49
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$87.10 / $112.20 / $141.25
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $3,981.07 / $3,981.07
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $114.82 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $169.82 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $120.23 / $208.93
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $54.95
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $81.28 / $199.53
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $123.03 / $199.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $117.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$57.54 / $100.00 / $190.55
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $100.00 / $181.97