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Kansas 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 $141 · 10th–90th $89–$2570%10%10th90th$141Professionalmedian $158 · 10th–90th $105–$3240%10%10th90th$158$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
$85.11 / $138.04 / $234.42
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$33.88 / $363.08 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $151.36 / $302.00
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$112.20 / $173.78 / $363.08
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $162.18 / $218.78
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$117.49 / $165.96 / $218.78
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $100.00 / $100.00
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $169.82 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$95.50 / $158.49 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $169.82 / $281.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $154.88 / $269.15
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $1,047.13
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$181.97 / $251.19 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $128.82 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $162.18 / $234.42
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $257.04