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Nevada 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 $324 · 10th–90th $129–$3240%50%10th$324Professionalmedian $182 · 10th–90th $115–$5250%10%20%10th90th$182$1.0$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $323.59 / $323.59
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $177.83 / $467.74
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $199.53 / $575.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $169.82 / $263.03
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$138.04 / $173.78 / $234.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $169.82 / $281.84
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$104.71 / $134.90 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $165.96 / $263.03
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $154.88 / $239.88
Hometown Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$660.69 / $660.69 / $660.69
Hometown Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $173.78 / $263.03
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $177.83 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $131.83 / $251.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $162.18 / $275.42
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $173.78 / $323.59