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Connecticut 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 $324 · 10th–90th $174–$5370%10%20%10th90th$324Professionalmedian $234 · 10th–90th $141–$5750%10%10th90th$234$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
$186.21 / $323.59 / $537.03
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$239.88 / $380.19 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $213.80 / $512.86
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$173.78 / $346.74 / $660.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $218.78 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $181.97 / $251.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $234.42 / $416.87
ConnectiCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $281.84 / $446.68
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $173.78 / $173.78
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $346.74 / $1,047.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $173.78 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $239.88 / $436.52
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$85.11 / $91.20 / $478.63