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Virginia 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 $68–$1820%10%20%10th90th$107Professionalmedian $110 · 10th–90th $66–$2510%10%20%10th90th$110$1.0$5.0$20.0$100.0$500.0$2.0K

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
$58.88 / $93.33 / $177.83
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$131.83 / $218.78 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $107.15 / $239.88
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $120.23 / $269.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $125.89 / $213.80
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $74.13 / $128.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $141.25 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $112.20 / $186.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $131.83 / $199.53
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $114.82 / $154.88
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $112.20 / $181.97
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $218.78
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $93.33 / $147.91
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $123.03 / $204.17
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $79.43 / $125.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $100.00 / $177.83
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $131.83 / $213.80