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Wisconsin 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 $110 · 10th–90th $71$2450%10%10th90th$110Professionalmedian $132 · 10th–90th $71$3240%5%10th90th$132$1.0$5.0$20.0$100.0$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
$72.44 / $128.82 / $245.47
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$79.43 / $213.80 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $112.20 / $316.23
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $151.36 / $346.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $138.04 / $257.04
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $100.00 / $144.54
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $131.83 / $245.47
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $346.74 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $173.78 / $316.23
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $95.50 / $186.21
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $204.17 / $288.40
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$66.07 / $97.72 / $213.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $239.88 / $691.83
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $263.03 / $331.13
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $100.00
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $154.88 / $275.42
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $186.21 / $295.12
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $512.86
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$83.18 / $162.18 / $691.83
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $131.83
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $165.96 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $67.61 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $229.09 / $363.08
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$72.44 / $97.72 / $177.83