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Oregon 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 $234 · 10th–90th $132–$3800%10%10th90th$234Professionalmedian $200 · 10th–90th $112–$4900%5%10%10th90th$200$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $245.47 / $426.58
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$144.54 / $380.19 / $575.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $190.55 / $467.74
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$125.89 / $213.80 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $218.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $245.47 / $398.11
HealthNet
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$380.19 / $436.52 / $467.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $295.12 / $426.58
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $190.55 / $323.59
Moda Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$223.87 / $380.19 / $575.44
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $234.42 / $398.11
Moda Health
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$128.82 / $218.78 / $537.03
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $309.03 / $331.13
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $186.21 / $323.59
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $295.12 / $416.87
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $309.03 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $131.83 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $245.47 / $380.19
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $295.12