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Nebraska 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 $209 · 10th–90th $112–$3390%10%10th90th$209Professionalmedian $182 · 10th–90th $105–$3720%5%10%10th90th$182$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
$97.72 / $239.88 / $354.81
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$123.03 / $123.03 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $162.18 / $354.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$125.89 / $257.04 / $380.19
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $208.93 / $331.13
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$141.25 / $257.04 / $371.54
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $338.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $223.87 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $173.78 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $218.78 / $389.05
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $181.97 / $281.84
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $302.00 / $831.76
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$245.47 / $316.23 / $407.38
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $263.03 / $323.59
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $281.84 / $371.54
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $288.40
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $190.55 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $177.83 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $194.98 / $346.74
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $181.97 / $263.03