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Colorado rates for HCPCS 99205

Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and high level of medical decision making. When using total time on the date of the encounter for code selection, 60 minutes must be met or exceeded.

Facilitymedian $174 · 10th–90th $120–$3240%20%10th90th$174Professionalmedian $229 · 10th–90th $145–$5620%10%20%10th90th$229$1.0$5.0$20.0$100.0$500.0$2.0K

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
$120.23 / $173.78 / $309.03
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$165.96 / $165.96 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $218.78 / $524.81
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$169.82 / $331.13 / $660.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $199.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $245.47 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $151.36 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $245.47 / $389.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $331.13 / $602.56
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $223.87 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $275.42 / $309.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $257.04 / $407.38
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$70.79 / $89.13 / $457.09