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West Virginia 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 $126 · 10th–90th $41–$2040%10%20%10th90th$126Professionalmedian $174 · 10th–90th $105–$3310%5%10%10th90th$174$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
$35.48 / $107.15 / $186.21
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$40.74 / $64.57 / $223.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $162.18 / $331.13
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$117.49 / $199.53 / $354.81
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $151.36 / $213.80
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $169.82 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $204.17 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $169.82 / $602.56
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $186.21 / $281.84
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$147.91 / $181.97 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $151.36 / $251.19
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$79.43 / $89.13 / $208.93