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Idaho 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 $191 · 10th–90th $107–$2820%10%10th90th$191Professionalmedian $191 · 10th–90th $115–$4470%5%10%10th90th$191$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
$48.98 / $213.80 / $281.84
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$117.49 / $117.49 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $181.97 / $436.52
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $213.80 / $524.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $316.23 / $316.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $269.15 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $199.53 / $295.12
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $177.83 / $295.12
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$117.49 / $117.49 / $501.19
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $194.98 / $380.19
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $218.78 / $524.81
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $323.59
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $213.80 / $316.23
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $186.21 / $316.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $190.55 / $302.00
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$87.10 / $89.13 / $263.03