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Florida 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 $145 · 10th–90th $102–$3800%10%10th90th$145Professionalmedian $174 · 10th–90th $107–$4070%5%10%10th90th$174$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
$102.33 / $141.25 / $371.54
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$125.89 / $251.19 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $169.82 / $380.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$117.49 / $199.53 / $457.09
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $169.82 / $229.09
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$131.83 / $173.78 / $239.88
AvMed
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $123.03 / $134.90
AvMed
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $147.91 / $186.21
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $181.97 / $257.04
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $177.83 / $316.23
Florida Blue
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $269.15 / $416.87
Florida Blue
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $144.54 / $208.93
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $141.25 / $269.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $125.89 / $177.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $151.36 / $275.42
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $194.98 / $323.59
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $128.82 / $177.83