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Arizona 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 $166 · 10th–90th $102–$1,4450%10%10th90th$166Professionalmedian $186 · 10th–90th $105–$4900%5%10%10th90th$186$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
$95.50 / $229.09 / $1,513.56
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$891.25 / $1,202.26 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $177.83 / $467.74
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$117.49 / $204.17 / $524.81
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $158.49 / $218.78
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $165.96 / $218.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $50.12
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $123.03 / $169.82
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $162.18 / $309.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $151.36 / $251.19
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $199.53 / $1,047.13
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$138.04 / $177.83 / $371.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $109.65 / $141.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $154.88 / $275.42
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $154.88 / $309.03