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Alabama rates for HCPCS 99204

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using total time on the date of the encounter for code selection, 45 minutes must be met or exceeded.

Facilitymedian $129 · 10th–90th $105–$1700%20%10th90th$129Professionalmedian $170 · 10th–90th $102–$3630%5%10%10th90th$170$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
$104.71 / $128.82 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $162.18 / $354.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$112.20 / $190.55 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $223.87
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $162.18 / $223.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $154.88 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $162.18 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $138.04 / $218.78
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $263.03