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Delaware 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 $174 · 10th–90th $105–$4470%10%20%10th90th$174Professionalmedian $170 · 10th–90th $102–$3720%5%10%10th90th$170$10.0$20.0$50.0$100.0$200.0$500.0$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
$104.71 / $173.78 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $162.18 / $363.08
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$123.03 / $204.17 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $131.83 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $165.96 / $281.84
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $120.23
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $199.53 / $302.00
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$144.54 / $173.78 / $389.05
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $147.91 / $263.03
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $89.13 / $257.04