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Rhode Island 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 $166 · 10th–90th $132–$6170%20%10th90th$166Professionalmedian $170 · 10th–90th $102–$3980%5%10%10th90th$170$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
$131.83 / $165.96 / $616.60
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$239.88 / $407.38 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $162.18 / $380.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$120.23 / $223.87 / $478.63
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $194.98 / $380.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $169.82 / $234.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $173.78 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $177.83 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $173.78 / $295.12
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$89.13 / $89.13 / $263.03