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Washington, DC 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 $302 · 10th–90th $129–$3980%10%10th90th$302Professionalmedian $174 · 10th–90th $98–$3720%5%10%10th90th$174$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
$128.82 / $302.00 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $162.18 / $354.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$109.65 / $194.98 / $398.11
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $112.20 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $165.96 / $316.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $199.53 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $128.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $162.18 / $295.12
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $371.54